1083641575 NPI number — KATHRYN M SAUNDERS APRN, CNP

Table of content: KATHRYN M SAUNDERS APRN, CNP (NPI 1083641575)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083641575 NPI number — KATHRYN M SAUNDERS APRN, CNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SAUNDERS
Provider First Name:
KATHRYN
Provider Middle Name:
M
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
APRN, CNP
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:
1083641575
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/26/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
529 S PATTEN RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PATTEN
Provider Business Mailing Address State Name:
ME
Provider Business Mailing Address Postal Code:
04765-3007
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
207-538-3700
Provider Business Mailing Address Fax Number:
855-674-1895

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
KATAHDIN VALLEY HEALTH CENTER
Provider Second Line Business Practice Location Address:
50 SUMMER STREET
Provider Business Practice Location Address City Name:
MILLINOCKET
Provider Business Practice Location Address State Name:
ME
Provider Business Practice Location Address Postal Code:
04462-1400
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
207-538-3700
Provider Business Practice Location Address Fax Number:
207-528-2880
Provider Enumeration Date:
06/28/2006

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: 208000000X , with the licence number:  CNP231213 , registered in the state of ME ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 367A00000X , with the licence number: 101-0022934 , registered in the state of VT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: OVN3337 , issued by the state of ( VT ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com