1801849625 NPI number — VERNA SHERMAN AGE CRNA

Table of content: DR. PAUL N ZEMBA DC (NPI 1841023306)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801849625 NPI number — VERNA SHERMAN AGE CRNA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
AGE
Provider First Name:
VERNA
Provider Middle Name:
SHERMAN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CRNA
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:
1801849625
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/22/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9290 MORRISON RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW ORLEANS
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70127-2200
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
504-241-7995
Provider Business Mailing Address Fax Number:
985-649-4908

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
58305 JEFFERSON AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SLIDELL
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70460-3814
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
504-908-6306
Provider Business Practice Location Address Fax Number:
985-649-4908
Provider Enumeration Date:
05/19/2006

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: 367500000X , with the licence number:  1109231 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 367500000X , with the licence number: RN041635-AP12621 , 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)

  • Identifier: 611077369 1295716850 . This is a "HEALTHNET" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000000671115 . This is a "ANTHEM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3075890 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 74012469 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 200992140 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".




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