1538497896 NPI number — MRS. TINA MARIE VANBUREN RN, MSN, CCRN, CCNS

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538497896 NPI number — MRS. TINA MARIE VANBUREN RN, MSN, CCRN, CCNS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VANBUREN
Provider First Name:
TINA
Provider Middle Name:
MARIE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
RN, MSN, CCRN, CCNS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MUNDY
Provider Other First Name:
TINA
Provider Other Middle Name:
MARIE
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
RN
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1538497896
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/25/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1200 S. CEDAR CREST BLVD.
Provider Second Line Business Mailing Address:
LEHIGH VALLEY PHYSICIANS GROUP
Provider Business Mailing Address City Name:
ALLENTOWN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18105-1556
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-402-8707
Provider Business Mailing Address Fax Number:
610-402-2364

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1200 S. CEDAR CREST BLVD
Provider Second Line Business Practice Location Address:
MICU 2K LEHIGH VALLEY HEALTH NETWORK
Provider Business Practice Location Address City Name:
ALLENTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18015-1556
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-402-8707
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/25/2009

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: 364S00000X , with the licence number:  RN297169L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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