1790017788 NPI number — MS. ERMA ROUSEY SCHLOTMAN R.N.

Table of content: MS. ERMA ROUSEY SCHLOTMAN R.N. (NPI 1790017788)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790017788 NPI number — MS. ERMA ROUSEY SCHLOTMAN R.N.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHLOTMAN
Provider First Name:
ERMA
Provider Middle Name:
ROUSEY
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
R.N.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SCHLOTMAN
Provider Other First Name:
ERMA
Provider Other Middle Name:
EMMA
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
R.N.
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1790017788
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/02/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8955 COLUMBIA AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MUNSTER
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
46321-2903
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
219-923-8110
Provider Business Mailing Address Fax Number:
219-923-4700

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8955 COLUMBIA AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MUNSTER
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46321-2903
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
219-923-8110
Provider Business Practice Location Address Fax Number:
219-923-4700
Provider Enumeration Date:
02/02/2010

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: 163WP0809X , with the licence number:  28054694 , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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