1790035509 NPI number — SARAH BURDEN FOLK FNP-BC

Table of content: SARAH BURDEN FOLK FNP-BC (NPI 1790035509)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790035509 NPI number — SARAH BURDEN FOLK FNP-BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FOLK
Provider First Name:
SARAH
Provider Middle Name:
BURDEN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
FNP-BC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BURDEN
Provider Other First Name:
SARAH
Provider Other Middle Name:
ELIZABETH
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
FNP-BC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1790035509
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/13/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2880 TRICOM ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
N CHARLESTON
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29406-9171
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
843-797-5050
Provider Business Mailing Address Fax Number:
843-797-3633

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2880 TRICOM ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
N CHARLESTON
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29406-9171
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
843-797-5050
Provider Business Practice Location Address Fax Number:
843-797-3633
Provider Enumeration Date:
09/19/2012

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:  18026 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: DU4331 . This is a "ARCIS HEALTHCARE GROUP RAILROAD MEDICARE PTAN" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: 1902246077 . This is a "ARCIS HEALTHCARE GROUP NPI" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: D043 . This is a "ARCIS HEALTHCARE MEDICARE PTAN" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: GP6337 . This is a "ARCIS HEALTHCARE MEDICAID GROUP LEGACY NO." identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: NP2969 , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".
  • Identifier: P01297621 . This is a "RAILROAD MEDICARE PTAN" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com