1437747656 NPI number — JAMIE LINN LADD NP-C

Table of content: JAMIE LINN LADD NP-C (NPI 1437747656)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437747656 NPI number — JAMIE LINN LADD NP-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LADD
Provider First Name:
JAMIE
Provider Middle Name:
LINN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
NP-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:
1437747656
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/12/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
700 N COLUMBUS ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CRESTLINE
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44827-1455
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
419-462-3485
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
24 E WHITNEY AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SHELBY
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44875-1282
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
567-247-0872
Provider Business Practice Location Address Fax Number:
567-247-0873
Provider Enumeration Date:
01/04/2021

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:  APRN.CNP.0027833 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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