1790091049 NPI number — MRS. CHRISTA BARBETTE ADAMS OTR

Table of content: MRS. CHRISTA BARBETTE ADAMS OTR (NPI 1790091049)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790091049 NPI number — MRS. CHRISTA BARBETTE ADAMS OTR

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ADAMS
Provider First Name:
CHRISTA
Provider Middle Name:
BARBETTE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
OTR
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:
1790091049
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/24/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9939 ROSE LEAF CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COLORADO SPRINGS
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80920-8402
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
719-597-5686
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2210 LELARAY ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COLORADO SPRINGS
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80909-2220
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
719-475-1021
Provider Business Practice Location Address Fax Number:
719-475-1021
Provider Enumeration Date:
08/24/2010

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: 225X00000X ; 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