1033581327 NPI number — MRS. CODIE WASHBURN A.T.C.

Table of content: MRS. CODIE WASHBURN A.T.C. (NPI 1033581327)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033581327 NPI number — MRS. CODIE WASHBURN A.T.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WASHBURN
Provider First Name:
CODIE
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
A.T.C.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HILTON
Provider Other First Name:
CODIE
Provider Other Middle Name:
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1033581327
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/26/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
UWA STATION #14
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LIVINGSTON
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35470
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
UWA STATION #14
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LIVINGSTON
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35470
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-652-3489
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/26/2015

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: 174400000X , with the licence number:  1550 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1550 . This is a "STATE LICENSURE" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 2000012354 . This is a "BOARD OF CERTIFICATION NUMBER" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com