1841300183 NPI number — MRS. KRISTEN PAIGE RICHARDSON ARNP

Table of content: MRS. KRISTEN PAIGE RICHARDSON ARNP (NPI 1841300183)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841300183 NPI number — MRS. KRISTEN PAIGE RICHARDSON ARNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RICHARDSON
Provider First Name:
KRISTEN
Provider Middle Name:
PAIGE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
ARNP
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:
1841300183
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/12/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1231 PARK PL NE
Provider Second Line Business Mailing Address:
SUITE FALCON
Provider Business Mailing Address City Name:
CEDAR RAPIDS
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
52402-2018
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
319-521-4716
Provider Business Mailing Address Fax Number:
319-294-9356

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1231 PARK PL NE
Provider Second Line Business Practice Location Address:
SUITE FALCON
Provider Business Practice Location Address City Name:
CEDAR RAPIDS
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
52402-2018
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
319-521-4716
Provider Business Practice Location Address Fax Number:
319-294-9356
Provider Enumeration Date:
08/30/2006

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: 363LP0808X , with the licence number:  G095377 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 202332407 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com