1386861805 NPI number — ASHELY ANN ZWEIFEL

Table of content: ASHELY ANN ZWEIFEL (NPI 1386861805)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386861805 NPI number — ASHELY ANN ZWEIFEL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ZWEIFEL
Provider First Name:
ASHELY
Provider Middle Name:
ANN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ROGGENKAMP
Provider Other First Name:
ASHLEY
Provider Other Middle Name:
ANN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1386861805
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/20/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 248
Provider Second Line Business Mailing Address:
100 N THOMPSON AVE
Provider Business Mailing Address City Name:
EXCELSIOR SPRINGS
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
64024-0248
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
816-630-9221
Provider Business Mailing Address Fax Number:
816-630-9207

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
EXCELSIOR SPRINGS PUBLIC SCHOOLS
Provider Second Line Business Practice Location Address:
100 N THOMPSON AVE
Provider Business Practice Location Address City Name:
EXCELSIOR SPRINGS
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64024-0248
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-630-9221
Provider Business Practice Location Address Fax Number:
816-630-9207
Provider Enumeration Date:
04/18/2007

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: 235Z00000X , with the licence number:  2005033263 , 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)

  • Identifier: 467573309 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".




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