1487097994 NPI number — PRIORITY PHYSICIANS, INC.

Table of content: KAITLYN MAE HALLWYLER LBSW (NPI 1902433493)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487097994 NPI number — PRIORITY PHYSICIANS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PRIORITY PHYSICIANS, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1487097994
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/11/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12174 N MERIDIAN ST STE 300
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CARMEL
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
46032-4578
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
317-688-9000
Provider Business Mailing Address Fax Number:
317-680-9900

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12174 N MERIDIAN ST STE 300
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CARMEL
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46032-4578
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
317-688-9000
Provider Business Practice Location Address Fax Number:
317-680-9900
Provider Enumeration Date:
04/15/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
RIZZUTO
Authorized Official First Name:
JOSEPH
Authorized Official Middle Name:
E.
Authorized Official Title or Position:
CHIEF OPERATING OFFICER
Authorized Official Telephone Number:
317-688-9000

Provider Taxonomy Codes

  • Taxonomy code: 261QP2300X , with the licence number:  50005073A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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