1740693670 NPI number — MRS. CHANNING C. DRUMMOND ACNP-BC

Table of content: MRS. CHANNING C. DRUMMOND ACNP-BC (NPI 1740693670)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740693670 NPI number — MRS. CHANNING C. DRUMMOND ACNP-BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DRUMMOND
Provider First Name:
CHANNING
Provider Middle Name:
C.
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
ACNP-BC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CLAWSON
Provider Other First Name:
CHANNING
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1740693670
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/16/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 10597
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AUSTIN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78766-1597
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
512-485-5889
Provider Business Mailing Address Fax Number:
512-420-0397

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7200 WYOMING SPRINGS DR STE 1300
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROUND ROCK
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78681-4306
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
512-244-2273
Provider Business Practice Location Address Fax Number:
512-924-4131
Provider Enumeration Date:
06/09/2014

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: 363L00000X , with the licence number:  1054101 , registered in the state of TX ; 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