1255391298 NPI number — MS. SARAH LYNNE SEMONES RN, MS, PMHCNS, NP-C

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255391298 NPI number — MS. SARAH LYNNE SEMONES RN, MS, PMHCNS, NP-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SEMONES
Provider First Name:
SARAH
Provider Middle Name:
LYNNE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
RN, MS, PMHCNS, NP-C
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:
1255391298
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/22/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
103 MELVINS END
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
YORKTOWN
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23693-2566
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
757-846-8237
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
103 MELVINS END
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
YORKTOWN
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23693-2566
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-846-8237
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/24/2006

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: 364SP0809X , with the licence number:  001500463 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LA2200X , with the licence number: 0024168429 , 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: 1255391298 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1255391298 . This is a "MEDICARE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com