1841637154 NPI number — RHONDA L BARRINEAU APRN

Table of content: RHONDA L BARRINEAU APRN (NPI 1841637154)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841637154 NPI number — RHONDA L BARRINEAU APRN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BARRINEAU
Provider First Name:
RHONDA
Provider Middle Name:
L
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
APRN
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:
1841637154
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/20/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
480 HOPKINSVILLE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GREENVILLE
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
42345-1124
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
270-338-5777
Provider Business Mailing Address Fax Number:
270-338-5765

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1497 NASHVILLE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RUSSELLVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42276
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-726-9568
Provider Business Practice Location Address Fax Number:
270-726-9570
Provider Enumeration Date:
05/28/2013

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:  3007968 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 7100283670 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".




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