1063695922 NPI number — OBY ANTHONIA ATTA CRNP

Table of content: OBY ANTHONIA ATTA CRNP (NPI 1063695922)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063695922 NPI number — OBY ANTHONIA ATTA CRNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ATTA
Provider First Name:
OBY
Provider Middle Name:
ANTHONIA
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CRNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ONWUZU
Provider Other First Name:
OBY
Provider Other Middle Name:
ANTHONIA
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1063695922
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/17/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3700 N CAPITOL ST NW
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WASHINGTON
Provider Business Mailing Address State Name:
DC
Provider Business Mailing Address Postal Code:
20011-8400
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
202-541-7695
Provider Business Mailing Address Fax Number:
202-541-7695

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3700 N CAPITOL ST NW
Provider Second Line Business Practice Location Address:
LAGARDE 2
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20011-8400
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-541-7695
Provider Business Practice Location Address Fax Number:
202-541-7699
Provider Enumeration Date:
12/13/2007

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: 363LF0000X , with the licence number:  RN960527 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363LF0000X , with the licence number: R152313 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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