1609854728 NPI number — MRS. CATHERINE O'FALLON VINZANI MSN, FNP

Table of content: MRS. CATHERINE O'FALLON VINZANI MSN, FNP (NPI 1609854728)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609854728 NPI number — MRS. CATHERINE O'FALLON VINZANI MSN, FNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VINZANI
Provider First Name:
CATHERINE
Provider Middle Name:
O'FALLON
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MSN, FNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
VINZANI
Provider Other First Name:
MARY
Provider Other Middle Name:
CATHERINE
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MSN, FNP
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1609854728
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/27/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5904 BAIRD DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RALEIGH
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27606-9444
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
919-834-5205
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2815 CATES AVE
Provider Second Line Business Practice Location Address:
BOX 7304
Provider Business Practice Location Address City Name:
RALEIGH
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27695-7304
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-513-2536
Provider Business Practice Location Address Fax Number:
188-897-2415
Provider Enumeration Date:
01/09/2006

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: 363LF0000X , with the licence number:  201634 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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