1801297148 NPI number — MS. GERILYN MAE HOLM CABI

Table of content: MS. GERILYN MAE HOLM CABI (NPI 1801297148)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801297148 NPI number — MS. GERILYN MAE HOLM CABI

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOLM
Provider First Name:
GERILYN
Provider Middle Name:
MAE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
CABI
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:
1801297148
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/05/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2700 E SUNSET RD
Provider Second Line Business Mailing Address:
#201
Provider Business Mailing Address City Name:
LAS VEGAS
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89120
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
702-270-3219
Provider Business Mailing Address Fax Number:
866-833-2056

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2700 E SUNSET RD
Provider Second Line Business Practice Location Address:
#201
Provider Business Practice Location Address City Name:
LAS VEGAS
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89120
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-270-3219
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/05/2014

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: 103K00000X , registered in the state of NV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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