1164417234 NPI number — MRS. ELVINA ANN LORRAINE CHERAMIE APRNC

Table of content: MRS. ELVINA ANN LORRAINE CHERAMIE APRNC (NPI 1164417234)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164417234 NPI number — MRS. ELVINA ANN LORRAINE CHERAMIE APRNC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHERAMIE
Provider First Name:
ELVINA
Provider Middle Name:
ANN LORRAINE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
APRNC
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:
1164417234
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:
114 W 63RD ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CUT OFF
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70345-3319
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
985-632-3938
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
133 W 112TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CUT OFF
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70345-3629
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
985-632-5567
Provider Business Practice Location Address Fax Number:
985-632-5573
Provider Enumeration Date:
09/15/2005

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: 363LW0102X , with the licence number:  RN047874 AP01206 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2024 www.npivalidator.com