1841426566 NPI number — MRS. BRENDA LANKFORD CHILDS RN

Table of content: MRS. BRENDA LANKFORD CHILDS RN (NPI 1841426566)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841426566 NPI number — MRS. BRENDA LANKFORD CHILDS RN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHILDS
Provider First Name:
BRENDA
Provider Middle Name:
LANKFORD
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
RN
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:
1841426566
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/09/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
16359 SUSSEX HWY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRIDGEVILLE
Provider Business Mailing Address State Name:
DE
Provider Business Mailing Address Postal Code:
19933-2966
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
302-337-7990
Provider Business Mailing Address Fax Number:
302-337-7998

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
20346 ENNIS RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GEORGETOWN
Provider Business Practice Location Address State Name:
DE
Provider Business Practice Location Address Postal Code:
19947-4108
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
302-856-1926
Provider Business Practice Location Address Fax Number:
302-856-1950
Provider Enumeration Date:
06/09/2009

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: 163WS0200X , with the licence number:  L1-0019456 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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