1104158872 NPI number — MS. DEBORAH ANN RYKEN MS, PLPC

Table of content: MS. DEBORAH ANN RYKEN MS, PLPC (NPI 1104158872)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1104158872 NPI number — MS. DEBORAH ANN RYKEN MS, PLPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RYKEN
Provider First Name:
DEBORAH
Provider Middle Name:
ANN
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MS, PLPC
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:
1104158872
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/05/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
510 S OAK ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BATES CITY
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
64011-9124
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
816-522-8866
Provider Business Mailing Address Fax Number:
816-690-8293

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
410B SE 3RD ST STE 101
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEES SUMMIT
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64063-2842
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-522-8866
Provider Business Practice Location Address Fax Number:
816-690-8293
Provider Enumeration Date:
02/05/2010

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: 101YP2500X , with the licence number:  2010002433 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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