1104210343 NPI number — MS. YOLANDA ELIZABETH RZEPKA PRIVATE SCRUB

Table of content: MS. YOLANDA ELIZABETH RZEPKA PRIVATE SCRUB (NPI 1104210343)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1104210343 NPI number — MS. YOLANDA ELIZABETH RZEPKA PRIVATE SCRUB

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RZEPKA
Provider First Name:
YOLANDA
Provider Middle Name:
ELIZABETH
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
PRIVATE SCRUB
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:
1104210343
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/25/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8913 E BELL RD STE 201
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SCOTTSDALE
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85260-1300
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
480-767-1900
Provider Business Mailing Address Fax Number:
480-767-0493

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8913 E BELL RD STE 201
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SCOTTSDALE
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85260-1300
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
480-767-1900
Provider Business Practice Location Address Fax Number:
480-767-0493
Provider Enumeration Date:
03/25/2015

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: 246ZC0007X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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