1265415756 NPI number — MRS. SHELIA C. GARNER LINK MS RD LDN CDE

Table of content: MRS. SHELIA C. GARNER LINK MS RD LDN CDE (NPI 1265415756)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265415756 NPI number — MRS. SHELIA C. GARNER LINK MS RD LDN CDE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GARNER LINK
Provider First Name:
SHELIA
Provider Middle Name:
C.
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MS RD LDN CDE
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GARNER
Provider Other First Name:
SHELIA
Provider Other Middle Name:
CAROLINE
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
MS RD LDN CDE
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1265415756
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/23/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 160
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEWPORT
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28570-0160
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
252-223-3914
Provider Business Mailing Address Fax Number:
252-223-3905

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
361B HOWARD BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEWPORT
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28570-0160
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-223-3914
Provider Business Practice Location Address Fax Number:
252-223-3905
Provider Enumeration Date:
11/29/2005

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: 133V00000X , with the licence number:  L000333 , 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)





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