1730361957 NPI number — DR. AMANDA NICOLE DOERING D.C.

Table of content: DR. AMANDA NICOLE DOERING D.C. (NPI 1730361957)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730361957 NPI number — DR. AMANDA NICOLE DOERING D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DOERING
Provider First Name:
AMANDA
Provider Middle Name:
NICOLE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.C.
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:
1730361957
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/29/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
THE VILLAGE MALL BAY 12
Provider Second Line Business Mailing Address:
RR1 BOX 10556
Provider Business Mailing Address City Name:
KINGSHILL
Provider Business Mailing Address State Name:
UNITED STATES VIRGIN ISLANDS
Provider Business Mailing Address Postal Code:
00850
Provider Business Mailing Address Country Code:
UM
Provider Business Mailing Address Telephone Number:
340-773-4300
Provider Business Mailing Address Fax Number:
340-773-4301

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
THE VILLAGE MALL BAY 12
Provider Second Line Business Practice Location Address:
RR1 BOX 10556
Provider Business Practice Location Address City Name:
KINGSHILL
Provider Business Practice Location Address State Name:
VIRGIN ISLANDS
Provider Business Practice Location Address Postal Code:
00850
Provider Business Practice Location Address Country Code:
UM
Provider Business Practice Location Address Telephone Number:
340-773-4300
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/29/2007

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: 111N00000X , with the licence number:  51 , registered in the state of VI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2024 www.npivalidator.com