1780913665 NPI number — MS. MELINDA MORNINGSTAR DOWDEN-KRUGER BS, CWPM

Table of content: MS. MELINDA MORNINGSTAR DOWDEN-KRUGER BS, CWPM (NPI 1780913665)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780913665 NPI number — MS. MELINDA MORNINGSTAR DOWDEN-KRUGER BS, CWPM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DOWDEN-KRUGER
Provider First Name:
MELINDA
Provider Middle Name:
MORNINGSTAR
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
BS, CWPM
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:
1780913665
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/24/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
229 CHURCHILL DRIVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RICHMOND
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40475
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
859-623-5096
Provider Business Mailing Address Fax Number:
859-624-1611

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
229 CHURCHILL DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RICHMOND
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40475
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-623-5096
Provider Business Practice Location Address Fax Number:
859-624-1611
Provider Enumeration Date:
12/23/2009

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: 174H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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