1659392884 NPI number — KAREN COLE BARTLE FNP

Table of content: KAREN COLE BARTLE FNP (NPI 1659392884)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659392884 NPI number — KAREN COLE BARTLE FNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BARTLE
Provider First Name:
KAREN
Provider Middle Name:
COLE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
FNP
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:
1659392884
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7101 JAHNKE RD
Provider Second Line Business Mailing Address:
SUITE 500
Provider Business Mailing Address City Name:
RICHMOND
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23225-4017
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
804-320-2751
Provider Business Mailing Address Fax Number:
804-673-9218

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7101 JAHNKE RD
Provider Second Line Business Practice Location Address:
SUITE 500
Provider Business Practice Location Address City Name:
RICHMOND
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23225-4017
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
804-320-2751
Provider Business Practice Location Address Fax Number:
804-673-9218
Provider Enumeration Date:
07/22/2006

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: 363LF0000X , with the licence number:  0024164730 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0017137269 . This is a "PRESCRIPTIVE AUTHORITY" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 0001170755 . This is a "REGISTERED NURSE LICENSE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 0024164730 . This is a "NURSE PRACTITIONER LICENS" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




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