1558553362 NPI number — MS. HEATHER M ERSPAMER II LPN

Table of content: MS. HEATHER M ERSPAMER II LPN (NPI 1558553362)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558553362 NPI number — MS. HEATHER M ERSPAMER II LPN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ERSPAMER
Provider First Name:
HEATHER
Provider Middle Name:
M
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
II
Provider Credential Text:
LPN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1558553362
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/15/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
36060 RICHARDSON GAP RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SCIO
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97374-9733
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
541-451-5256
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4455 NE HIGHWAY 20
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CORVALLIS
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97330-9695
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-758-5900
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/15/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 164W00000X , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)