1245431410 NPI number — MRS. ANNE KATHERINE WHITEHEAD RN

Table of content: MRS. ANNE KATHERINE WHITEHEAD RN (NPI 1245431410)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245431410 NPI number — MRS. ANNE KATHERINE WHITEHEAD RN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WHITEHEAD
Provider First Name:
ANNE
Provider Middle Name:
KATHERINE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
RN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CROWLEY
Provider Other First Name:
ANNE
Provider Other Middle Name:
KATHERINE
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1245431410
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:
7210 HILL TOP RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
UPPER DARBY
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19082
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-352-5527
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5600 CITY AVE
Provider Second Line Business Practice Location Address:
ST JOSEPHS UNIV HEALTH CENTER
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19131-1308
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-660-1175
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/29/2007

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: 163W00000X , with the licence number:  RN294020L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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