1417964727 NPI number — DAWN M SPRINGER NURSE PRACTITIONER

Table of content: DAWN M SPRINGER NURSE PRACTITIONER (NPI 1417964727)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417964727 NPI number — DAWN M SPRINGER NURSE PRACTITIONER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SPRINGER
Provider First Name:
DAWN
Provider Middle Name:
M
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
NURSE PRACTITIONER
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LINDAMER
Provider Other First Name:
DAWN
Provider Other Middle Name:
M
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
NURSE PRACTITIONER
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1417964727
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/08/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6255 SHERIDAN DR
Provider Second Line Business Mailing Address:
SUITE 304
Provider Business Mailing Address City Name:
WILLIAMSVILLE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14221-4836
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
716-857-8666
Provider Business Mailing Address Fax Number:
716-630-1054

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
295 ESSJAY RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WILLIAMSVILLE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14221-8216
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
716-630-1000
Provider Business Practice Location Address Fax Number:
716-877-3812
Provider Enumeration Date:
08/01/2006

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: 363LF0000X , with the licence number:  F332916-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 00026535001 . This is a "UNIVERA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 02074202 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 500012876 . This is a "RR MEDICARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 161000580 . This is a "NOVA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 000560545001 . This is a "HEALTH NOW" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 9512239 . This is a "IHA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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