1033595673 NPI number — KADI LEPI ADDY WHNP-BC

Table of content: KADI LEPI ADDY WHNP-BC (NPI 1033595673)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033595673 NPI number — KADI LEPI ADDY WHNP-BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ADDY
Provider First Name:
KADI
Provider Middle Name:
LEPI
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
WHNP-BC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LEPI
Provider Other First Name:
KADI
Provider Other Middle Name:
E
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
WHNP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1033595673
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/31/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
716 ADAIR AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ZANESVILLE
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43701-2836
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
740-891-9000
Provider Business Mailing Address Fax Number:
740-891-9001

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1330 CLARK ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CAMBRIDGE
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43725-9614
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
740-421-9530
Provider Business Practice Location Address Fax Number:
740-421-9531
Provider Enumeration Date:
08/05/2015

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: 363LW0102X , with the licence number:  APRNCNP17918 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0142341 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




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