1942039987 NPI number — A BRIGHTER FUTURE KENTUCKY

Table of content: CLAIRE ELIZABETH GRAMZA CRNA (NPI 1902325970)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942039987 NPI number — A BRIGHTER FUTURE KENTUCKY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
A BRIGHTER FUTURE KENTUCKY
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1942039987
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/29/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2007
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ASHLAND
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
41105-2007
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
304-412-4086
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CYNTHIA TOLLIVER
Provider Second Line Business Practice Location Address:
1127 RIVENDELL DR
Provider Business Practice Location Address City Name:
ASHLAND
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41105
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-412-4086
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/29/2024

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
TOLLIVER
Authorized Official First Name:
CYNTHIA
Authorized Official Middle Name:
ROBIN
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
304-412-4086

Provider Taxonomy Codes

  • Taxonomy code: 320900000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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