1780843912 NPI number — JENNIFER MCENTEE M.D.

Table of content: JENNIFER MCENTEE M.D. (NPI 1780843912)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780843912 NPI number — JENNIFER MCENTEE M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCENTEE
Provider First Name:
JENNIFER
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
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:
1780843912
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/06/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
101 MANNING DR
Provider Second Line Business Mailing Address:
UNC- CHAPEL HILL
Provider Business Mailing Address City Name:
CHAPEL HILL
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27514-4220
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
919-974-1931
Provider Business Mailing Address Fax Number:
984-974-2216

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
101 MANNING DR
Provider Second Line Business Practice Location Address:
UNC- CHAPEL HILL HOSPITAL
Provider Business Practice Location Address City Name:
CHAPEL HILL
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27514-4220
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
984-974-1931
Provider Business Practice Location Address Fax Number:
984-974-2216
Provider Enumeration Date:
06/03/2008

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: 207R00000X , with the licence number:  55119 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208M00000X , with the licence number: 2014-00589 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207RH0002X , with the licence number: 2014-00589 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208000000X , with the licence number: 2014-00589 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2080H0002X , with the licence number: 2014-00589 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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