1598990863 NPI number — MRS. TONIA SCHIPULL RN WHNP BC

Table of content: MRS. TONIA SCHIPULL RN WHNP BC (NPI 1598990863)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598990863 NPI number — MRS. TONIA SCHIPULL RN WHNP BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHIPULL
Provider First Name:
TONIA
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
RN WHNP BC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CLARK
Provider Other First Name:
TONIA
Provider Other Middle Name:
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
RN WHNP BC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1598990863
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/15/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1322 N 36TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAINT JOSEPH
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
64506-2365
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
816-364-1944
Provider Business Mailing Address Fax Number:
816-236-2449

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1322 N 36TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAINT JOSEPH
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64506-2365
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-364-1944
Provider Business Practice Location Address Fax Number:
816-236-2449
Provider Enumeration Date:
05/15/2009

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: 363LW0102X , with the licence number:  071751 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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