1942315593 NPI number — ALAINE LESLIE PRIBISKO CRNA

Table of content: ALAINE LESLIE PRIBISKO CRNA (NPI 1942315593)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942315593 NPI number — ALAINE LESLIE PRIBISKO CRNA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PRIBISKO
Provider First Name:
ALAINE
Provider Middle Name:
LESLIE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CRNA
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:
1942315593
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/05/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1700 BAITY HILL DR
Provider Second Line Business Mailing Address:
UNIT 311
Provider Business Mailing Address City Name:
CHAPEL HILL
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27514-3957
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
704-560-6285
Provider Business Mailing Address Fax Number:
919-914-6148

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
DUKE MEDICINE
Provider Second Line Business Practice Location Address:
ERWIN ROAD
Provider Business Practice Location Address City Name:
DURHAM
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27710-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-684-3895
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/21/2006

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: 367500000X , with the licence number:  35469 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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