1740299221 NPI number — DR. MICHELE R KROHN-HARPER DC

Table of content: DR. MICHELE R KROHN-HARPER DC (NPI 1740299221)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740299221 NPI number — DR. MICHELE R KROHN-HARPER DC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KROHN-HARPER
Provider First Name:
MICHELE
Provider Middle Name:
R
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
KROHN
Provider Other First Name:
MICHELE
Provider Other Middle Name:
RENEE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
DC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1740299221
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/13/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5138 BLAZER PKWY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DUBLIN
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43017-1339
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
614-799-2260
Provider Business Mailing Address Fax Number:
614-799-2963

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5138 BLAZER PKWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DUBLIN
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43017-1339
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
614-799-2260
Provider Business Practice Location Address Fax Number:
614-799-2963
Provider Enumeration Date:
08/05/2006

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: 111NN1001X , with the licence number:  2314 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 5515575 . This is a "AETNA" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 1774924 . This is a "HEALTHSTAR" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




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