1114947827 NPI number — PROF. ELLEN MARIE SCARR RNC, FNP

Table of content: PROF. ELLEN MARIE SCARR RNC, FNP (NPI 1114947827)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114947827 NPI number — PROF. ELLEN MARIE SCARR RNC, FNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCARR
Provider First Name:
ELLEN
Provider Middle Name:
MARIE
Provider Name Prefix Text:
PROF.
Provider Name Suffix Text:
Provider Credential Text:
RNC, FNP
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:
1114947827
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:
2 KORET WAY, BOX 0606
Provider Second Line Business Mailing Address:
UNIVERSITY OF CALIFORNIA, SAN FRA
Provider Business Mailing Address City Name:
SAN FRANCISCO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94143-0606
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
415-476-4431
Provider Business Mailing Address Fax Number:
415-753-2161

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2330 POST ST
Provider Second Line Business Practice Location Address:
SUITE 360
Provider Business Practice Location Address City Name:
SAN FRANCISCO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94115-3465
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
415-353-7332
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/19/2006

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: 363LF0000X , with the licence number:  258452 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: NPF 4172 . This is a "NP FURNISHING NUMBER" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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