1801043419 NPI number — MRS. CHERI ANN PAZOS NP

Table of content: MRS. CHERI ANN PAZOS NP (NPI 1801043419)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801043419 NPI number — MRS. CHERI ANN PAZOS NP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PAZOS
Provider First Name:
CHERI
Provider Middle Name:
ANN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
NP
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:
1801043419
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/11/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4232 WILLIAMS BLVD
Provider Second Line Business Mailing Address:
SUITE 101
Provider Business Mailing Address City Name:
KENNER
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70065-2271
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
504-471-4880
Provider Business Mailing Address Fax Number:
504-471-4882

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4232 WILLIAMS BLVD
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
KENNER
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70065-2271
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
504-471-4880
Provider Business Practice Location Address Fax Number:
504-471-4882
Provider Enumeration Date:
08/26/2008

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:  1952 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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