1013235209 NPI number — MISS LYDA ELIZABETH FINCHAM M.S.

Table of content: MISS LYDA ELIZABETH FINCHAM M.S. (NPI 1013235209)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013235209 NPI number — MISS LYDA ELIZABETH FINCHAM M.S.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FINCHAM
Provider First Name:
LYDA
Provider Middle Name:
ELIZABETH
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
M.S.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FINCHAM
Provider Other First Name:
LYDA
Provider Other Middle Name:
ELIZABETH
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.S.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1013235209
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/29/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
809 E SOUTH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BELOIT
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
67420-3325
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
785-534-7090
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
113 E MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BELOIT
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67420-3234
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-534-7090
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/12/2010

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: 106H00000X , with the licence number:  807 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2024 www.npivalidator.com