1679064729 NPI number — MRS. CATHERINE ASSINK

Table of content: MRS. CATHERINE ASSINK (NPI 1679064729)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679064729 NPI number — MRS. CATHERINE ASSINK

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ASSINK
Provider First Name:
CATHERINE
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
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:
1679064729
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/08/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 9007
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHARLOTTESVILLE
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22906-9007
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2955 IVY RD STE 304
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHARLOTTESVILLE
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22903-9353
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
434-243-4570
Provider Business Practice Location Address Fax Number:
434-295-5491
Provider Enumeration Date:
05/24/2018

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: 367A00000X , with the licence number:  RN262021 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 367A00000X , with the licence number: 0024181727 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: RN262021 . This is a "GEORGIA SECRETARY OF STATE" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: F06181127 . This is a "AMERICAN ACADEMY OF NURSE PRACTITIONERS NATIONAL CERTIFICATION BOARD" identifier . This identifiers is of the category "OTHER".
  • Identifier: CNM04825 . This is a "AMERICAN MIDWIFERY CERTIFICATION" identifier . This identifiers is of the category "OTHER".




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