1396942181 NPI number — DR. JENNIFER NADINE SLIM D.O.

Table of content: DR. JENNIFER NADINE SLIM D.O. (NPI 1396942181)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396942181 NPI number — DR. JENNIFER NADINE SLIM D.O.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SLIM
Provider First Name:
JENNIFER
Provider Middle Name:
NADINE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.O.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BLEVINS
Provider Other First Name:
JENNIFER
Provider Other Middle Name:
NADINE
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
D.O.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1396942181
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/31/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
533 BOLIVAR ST
Provider Second Line Business Mailing Address:
ROOM 504, HEMATOLOGY ONCOLOGY
Provider Business Mailing Address City Name:
NEW ORLEANS
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70112-1349
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
504-903-2345
Provider Business Mailing Address Fax Number:
504-903-0217

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
533 BOLIVAR ST
Provider Second Line Business Practice Location Address:
ROOM 504, HEMATOLOGY ONCOLOGY
Provider Business Practice Location Address City Name:
NEW ORLEANS
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70112-1349
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
504-903-2345
Provider Business Practice Location Address Fax Number:
504-903-0217
Provider Enumeration Date:
06/27/2007

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: 207R00000X , with the licence number:  0102202376 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X , with the licence number: P7569 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RH0003X , with the licence number: DO000384 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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