1083690531 NPI number — MISS TRINA CHERIEE' WHEELER HS

Table of content: MISS TRINA CHERIEE' WHEELER HS (NPI 1083690531)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083690531 NPI number — MISS TRINA CHERIEE' WHEELER HS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WHEELER
Provider First Name:
TRINA
Provider Middle Name:
CHERIEE'
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
HS
Provider Gender Code:
F

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:
1083690531
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:
COMDT (CG-1122), U.S.COAST GUARD, 2100 2ND ST SW
Provider Second Line Business Mailing Address:
SUITE 5314
Provider Business Mailing Address City Name:
WASHINTON
Provider Business Mailing Address State Name:
DC
Provider Business Mailing Address Postal Code:
20593
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
907-463-2140
Provider Business Mailing Address Fax Number:
907-463-2150

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
COMDT (CG-1122), U.S.COAST GUARD,
Provider Second Line Business Practice Location Address:
2100 2ND ST SW, SUITE 5314
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20593-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
907-463-2140
Provider Business Practice Location Address Fax Number:
907-463-2150
Provider Enumeration Date:
12/16/2005

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: 171000000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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