1295574333 NPI number — EMILY J MOOREFIELD RN HEALTH COACH

Table of content: HIMANSHU V CHANDARANA M.D. (NPI 1114915444)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295574333 NPI number — EMILY J MOOREFIELD RN HEALTH COACH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MOOREFIELD
Provider First Name:
EMILY
Provider Middle Name:
J
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
RN HEALTH COACH
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:
1295574333
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/20/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1565 MOOREFIELD RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DANBURY
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27016-7006
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
336-407-6049
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7855 DORAL DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TOBACCOVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27050-9002
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-741-1319
Provider Business Practice Location Address Fax Number:
336-232-9677
Provider Enumeration Date:
05/20/2024

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: 171400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 163W00000X , with the licence number: 16503 , 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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