1700198132 NPI number — ALYCIA MARIE KAPIOTIS CRNP

Table of content: ALYCIA MARIE KAPIOTIS CRNP (NPI 1700198132)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700198132 NPI number — ALYCIA MARIE KAPIOTIS CRNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KAPIOTIS
Provider First Name:
ALYCIA
Provider Middle Name:
MARIE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CRNP
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:
1700198132
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/02/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
26920 POLLARD RD APT 818
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DAPHNE
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
36526-5150
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
251-367-5454
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7293 ROSCOE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GULF SHORES
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
36542
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
251-923-2135
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/14/2010

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:  ARNP9324874 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: 1-106245 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 011846 . This is a "MEDICARE GROUP NUMBER" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 631300001 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 692990700 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".