1881749521 NPI number — MRS. COLLEEN ANGELA LINENBERGER RN

Table of content: MRS. COLLEEN ANGELA LINENBERGER RN (NPI 1881749521)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881749521 NPI number — MRS. COLLEEN ANGELA LINENBERGER RN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LINENBERGER
Provider First Name:
COLLEEN
Provider Middle Name:
ANGELA
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:
BONIFATE
Provider Other First Name:
COLLEEN
Provider Other Middle Name:
ANGELA
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
NONE
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1881749521
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1119 VARE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15205-3813
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
UNIVERSITY DRIVE C
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15240-0000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-688-6221
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/24/2007

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: 163WC0200X , with the licence number:  RN549697 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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