1245227099 NPI number — DONNA RAE DOBSON-TOBIN NP, APRN

Table of content: DONNA RAE DOBSON-TOBIN NP, APRN (NPI 1245227099)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245227099 NPI number — DONNA RAE DOBSON-TOBIN NP, APRN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DOBSON-TOBIN
Provider First Name:
DONNA
Provider Middle Name:
RAE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
NP, APRN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DOBSON
Provider Other First Name:
DONNA
Provider Other Middle Name:
RAE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
RN
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1245227099
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/18/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 30374
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BILLINGS
Provider Business Mailing Address State Name:
MT
Provider Business Mailing Address Postal Code:
59107-0374
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
406-248-3175
Provider Business Mailing Address Fax Number:
406-248-3821

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3251 W 9TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WATERLOO
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
50702-5310
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
319-234-2893
Provider Business Practice Location Address Fax Number:
319-234-0354
Provider Enumeration Date:
10/05/2005

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: 363LP0808X , with the licence number:  17912 , registered in the state of MT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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