1952355950 NPI number — JENNIFER ANN ATKINSON ACNP

Table of content: JENNIFER ANN ATKINSON ACNP (NPI 1952355950)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952355950 NPI number — JENNIFER ANN ATKINSON ACNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ATKINSON
Provider First Name:
JENNIFER
Provider Middle Name:
ANN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
ACNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CRAWFORD
Provider Other First Name:
JENNIFER
Provider Other Middle Name:
ANN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
CNP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1952355950
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/21/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
103 MCKNIGHT DR
Provider Second Line Business Mailing Address:
SUITE A
Provider Business Mailing Address City Name:
MIDDLETOWN
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45044-4890
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
513-217-6400
Provider Business Mailing Address Fax Number:
513-217-6037

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
103 MCKNIGHT DR
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
MIDDLETOWN
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45044-4890
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-217-6400
Provider Business Practice Location Address Fax Number:
513-217-6037
Provider Enumeration Date:
05/22/2006

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: 363LA2100X , with the licence number:  NP05239 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363LA2100X , with the licence number: RN247919 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 328178 . This is a "AMERIGROUP" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 208679830031 . This is a "CARESOURCE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 2332238 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000000524479 . This is a "ANTHEM" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com