1255469102 NPI number — MRS. ANNE WHITNEY ENSOR DPT, WCS

Table of content: MRS. ANNE WHITNEY ENSOR DPT, WCS (NPI 1255469102)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255469102 NPI number — MRS. ANNE WHITNEY ENSOR DPT, WCS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ENSOR
Provider First Name:
ANNE
Provider Middle Name:
WHITNEY
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
DPT, WCS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
TUCKER
Provider Other First Name:
ANNE
Provider Other Middle Name:
WHITNEY
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1255469102
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/04/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
800 CRESCENT CENTRE DR STE 600
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FRANKLIN
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37067-7286
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-373-7116
Provider Business Mailing Address Fax Number:
615-221-9054

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6420 DUTCHMANS PKWY STE 160
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOUISVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40205-3353
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-373-1050
Provider Business Practice Location Address Fax Number:
502-373-1051
Provider Enumeration Date:
03/01/2007

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: 225100000X , with the licence number:  05004742 , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225100000X , with the licence number: 002620 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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