1861454381 NPI number — MRS. VIRGINIA KATHLEEN AUSTIN RN, BSN, RNFA

Table of content: MRS. VIRGINIA KATHLEEN AUSTIN RN, BSN, RNFA (NPI 1861454381)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861454381 NPI number — MRS. VIRGINIA KATHLEEN AUSTIN RN, BSN, RNFA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
AUSTIN
Provider First Name:
VIRGINIA
Provider Middle Name:
KATHLEEN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
RN, BSN, RNFA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FORD
Provider Other First Name:
VIRGINIA
Provider Other Middle Name:
KATHLEEN
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
RN, BSN, RNFA
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1861454381
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/20/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9999 BOAT CLUB RD
Provider Second Line Business Mailing Address:
#601
Provider Business Mailing Address City Name:
FORT WORTH
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76179-4091
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
817-907-2918
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9999 BOAT CLUB RD
Provider Second Line Business Practice Location Address:
#601
Provider Business Practice Location Address City Name:
FORT WORTH
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76179-4091
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
817-907-2918
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/03/2006

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: 163W00000X , with the licence number:  648218 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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