1033981782 NPI number — MRS. CAROLINE ISABEL NUNAMAKER MAT, ATC, LAT

Table of content: MRS. CAROLINE ISABEL NUNAMAKER MAT, ATC, LAT (NPI 1033981782)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033981782 NPI number — MRS. CAROLINE ISABEL NUNAMAKER MAT, ATC, LAT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NUNAMAKER
Provider First Name:
CAROLINE
Provider Middle Name:
ISABEL
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MAT, ATC, LAT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
STEVENS
Provider Other First Name:
CAROLINE
Provider Other Middle Name:
ISABEL
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1033981782
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/27/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7913 NW TWILIGHT PL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PARKVILLE
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
64152-6044
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
573-424-6443
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6310 LEWIS RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64132-3200
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
573-424-6443
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/26/2023

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: 2255A2300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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