1093959918 NPI number — SHARON C. A. RUPRECHT-BROWN LPTA

Table of content: SHARON C. A. RUPRECHT-BROWN LPTA (NPI 1093959918)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093959918 NPI number — SHARON C. A. RUPRECHT-BROWN LPTA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RUPRECHT-BROWN
Provider First Name:
SHARON
Provider Middle Name:
C. A.
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LPTA
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:
1093959918
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/22/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6711 AUTUMN WOOD DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SPOTSYLVANIA
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22553-1861
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
540-322-7872
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6711 AUTUMN WOOD DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPOTSYLVANIA
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22553-1861
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-322-7872
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/22/2009

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: 225200000X , with the licence number:  2306001190 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 2306001190 . This is a "PHYSICAL THERAPIST ASSISTANT" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com