1255882478 NPI number — ELLEN MARGARET NEWHOUSE APRN

Table of content: ALLISON E ACKMANN MA, CCC-SLP (NPI 1760871453)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255882478 NPI number — ELLEN MARGARET NEWHOUSE APRN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NEWHOUSE
Provider First Name:
ELLEN
Provider Middle Name:
MARGARET
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
APRN
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:
1255882478
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/11/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 390
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HUNTINGTON
Provider Business Mailing Address State Name:
WV
Provider Business Mailing Address Postal Code:
25708-0390
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
304-429-1088
Provider Business Mailing Address Fax Number:
304-429-3109

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
108 W MADISON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOUISA
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41230-1327
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-826-0341
Provider Business Practice Location Address Fax Number:
606-826-0349
Provider Enumeration Date:
10/24/2016

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: 363LF0000X , with the licence number:  APRN40531-FNP-BC , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: 3010656 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0308110 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1255882478 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7100482340 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".




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