1336389659 NPI number — MRS. JENNIFER RAPIEN CAMERON LISW

Table of content: MRS. JENNIFER RAPIEN CAMERON LISW (NPI 1336389659)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336389659 NPI number — MRS. JENNIFER RAPIEN CAMERON LISW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CAMERON
Provider First Name:
JENNIFER
Provider Middle Name:
RAPIEN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LISW
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:
1336389659
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/11/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
50 IRVING ST NW
Provider Second Line Business Mailing Address:
RM. 2K-206
Provider Business Mailing Address City Name:
WASHINGTON
Provider Business Mailing Address State Name:
DC
Provider Business Mailing Address Postal Code:
20422-0001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
202-745-2283
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
50 IRVING STREET
Provider Second Line Business Practice Location Address:
RM. 2K-201
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20422
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-745-2283
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/26/2009

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: 104100000X , with the licence number:  I. 0008247 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com