1346375821 NPI number — DR. LAURA ANNE PRIEBE BELMAR D.C.

Table of content: DR. LAURA ANNE PRIEBE BELMAR D.C. (NPI 1346375821)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346375821 NPI number — DR. LAURA ANNE PRIEBE BELMAR D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PRIEBE BELMAR
Provider First Name:
LAURA
Provider Middle Name:
ANNE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.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:
1346375821
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/24/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
689 TAMIAMI TRL N
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NAPLES
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34102-8100
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
239-262-0606
Provider Business Mailing Address Fax Number:
239-262-3482

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
689 TAMIAMI TRL N
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NAPLES
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34102-8100
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
239-262-0606
Provider Business Practice Location Address Fax Number:
239-262-3482
Provider Enumeration Date:
02/23/2007

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: 111N00000X , with the licence number:  CH11312 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 111N00000X , with the licence number: 006517 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 1006248 . This is a "CIGNA-ASHN PROV #" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 105142 . This is a "BLUE CROSS PROV #" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 296259 . This is a "HEALTHLINK PROV #" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: P00244094 . This is a "MEDICARE RR PROV #" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 231771 . This is a "GHP PROVIDER #" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 5180315 . This is a "AETNA PROVIDER #" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".




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