1447226279 NPI number — KATHLEEN R DOYLE-ERRTHUM MSW

Table of content: KATHLEEN R DOYLE-ERRTHUM MSW (NPI 1447226279)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447226279 NPI number — KATHLEEN R DOYLE-ERRTHUM MSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DOYLE-ERRTHUM
Provider First Name:
KATHLEEN
Provider Middle Name:
R
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MSW
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:
1447226279
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
369 E COLLEGE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
IOWA CITY
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
52240-1690
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
319-339-4757
Provider Business Mailing Address Fax Number:
319-656-2085

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
369 E COLLEGE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
IOWA CITY
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
52240-1690
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
319-339-4757
Provider Business Practice Location Address Fax Number:
319-656-2085
Provider Enumeration Date:
02/23/2006

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: 101YP2500X , with the licence number:  02806 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 19937 . This is a "BLUE CROSS PROVIDER NUMBE" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com