1750334785 NPI number — MRS. CATHLEEN M ALBERS WHNP

Table of content: MRS. CATHLEEN M ALBERS WHNP (NPI 1750334785)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750334785 NPI number — MRS. CATHLEEN M ALBERS WHNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALBERS
Provider First Name:
CATHLEEN
Provider Middle Name:
M
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
WHNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MACLEOD
Provider Other First Name:
CATHLEEN
Provider Other Middle Name:
M
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
WHNP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1750334785
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/31/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10777 SUNSET OFFICE DR
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
SAINT LOUIS
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
63127-1019
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
314-842-4802
Provider Business Mailing Address Fax Number:
314-849-8721

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10777 SUNSET OFFICE DR
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
SAINT LOUIS
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63127-1019
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
314-842-4802
Provider Business Practice Location Address Fax Number:
314-849-8721
Provider Enumeration Date:
05/19/2006

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: 363LW0102X , with the licence number:  047914 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: P01223035 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 1750334785 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".




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