1457398000 NPI number — JOAN KRAEMER COMPERE MSW LCSW C

Table of content: CELESTE JEANNINE MARIA DAY CRNA (NPI 1295800217)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457398000 NPI number — JOAN KRAEMER COMPERE MSW LCSW C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COMPERE
Provider First Name:
JOAN
Provider Middle Name:
KRAEMER
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MSW LCSW 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:
1457398000
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:
120 SISTER PIERRE DRIVE
Provider Second Line Business Mailing Address:
SUITE 403
Provider Business Mailing Address City Name:
TOWSON
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21204
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-823-6408
Provider Business Mailing Address Fax Number:
443-279-0537

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7130 MINSTREL WAY
Provider Second Line Business Practice Location Address:
SUITE 212
Provider Business Practice Location Address City Name:
COLUMBIA
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21045
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-290-6940
Provider Business Practice Location Address Fax Number:
410-290-9763
Provider Enumeration Date:
06/01/2006

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: 1041C0700X , with the licence number:  05054 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0004 . This is a "BSDC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 226105 . This is a "KAIS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 252450 . This is a "COMP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 331944 . This is a "MHN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 150N . This is a "MBMD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 360218 . This is a "MHN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 54264705 . This is a "BSMD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 253538 . This is a "COMP" identifier . This identifiers is of the category "OTHER".
  • Identifier: PVPB117102 . This is a "APS" identifier . This identifiers is of the category "OTHER".
  • Identifier: K452 . This is a "BSDC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 150B127G . This is a "MBMD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 705BPS . This is a "BSMD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2139991 . This is a "MAMS" identifier . This identifiers is of the category "OTHER".




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