1184341885 NPI number — MS. BRITTANY NOELLE NIGGEMAN RDH

Table of content: MS. BRITTANY NOELLE NIGGEMAN RDH (NPI 1184341885)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184341885 NPI number — MS. BRITTANY NOELLE NIGGEMAN RDH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NIGGEMAN
Provider First Name:
BRITTANY
Provider Middle Name:
NOELLE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
RDH
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:
1184341885
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/24/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
706 W 8TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
JOHNSTON CITY
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
62951-1260
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
618-889-2131
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7562 OLD ROUTE 13
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MARION
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
62959-7776
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
618-993-8333
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/24/2022

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: 124Q00000X , with the licence number:  020.012467 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2024 www.npivalidator.com