1134318843 NPI number — MS. ASHLEY MILES HONEYCUTT L.D.N., R.D.

Table of content: MS. NGOC TAT (NPI 1235808908)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134318843 NPI number — MS. ASHLEY MILES HONEYCUTT L.D.N., R.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HONEYCUTT
Provider First Name:
ASHLEY
Provider Middle Name:
MILES
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
L.D.N., R.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MILES
Provider Other First Name:
ASHLEY
Provider Other Middle Name:
LYNNE
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
LDN,RD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1134318843
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/14/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
211 FRIDAY CENTER DR
Provider Second Line Business Mailing Address:
SUITE 2091, ROOM 2094 HEDRICK BUILDING
Provider Business Mailing Address City Name:
CHAPEL HILL
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27517-9499
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
984-974-1191
Provider Business Mailing Address Fax Number:
984-974-1311

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4200 LAKE BOONE TRL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RALEIGH
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27607-6521
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-784-1371
Provider Business Practice Location Address Fax Number:
919-784-1397
Provider Enumeration Date:
10/18/2007

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: 133N00000X , with the licence number:  L002818 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 133NN1002X , with the licence number: 002818 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 133V00000X , with the licence number: L002818 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: Q50640E853 . This is a "MEDICARE PTAN" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: Q50640A . This is a "MEDICARE PTAN" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".




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