1356324651 NPI number — ROBIN RAE CAHILL-MYERS ARNP

Table of content: ROBIN RAE CAHILL-MYERS ARNP (NPI 1356324651)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356324651 NPI number — ROBIN RAE CAHILL-MYERS ARNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CAHILL-MYERS
Provider First Name:
ROBIN
Provider Middle Name:
RAE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
ARNP
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:
1356324651
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/14/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
920 2ND AVE S
Provider Second Line Business Mailing Address:
SUITE 400
Provider Business Mailing Address City Name:
MINNEAPOLIS
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55402-3318
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
612-251-1512
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
920 2ND AVE S STE 400
Provider Second Line Business Practice Location Address:
MINUTE CLINIC DIAGNOSITIC OF WA, LLC
Provider Business Practice Location Address City Name:
MINNEAPOLIS
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55402-4010
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
612-225-1512
Provider Business Practice Location Address Fax Number:
612-659-7101
Provider Enumeration Date:
11/22/2005

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: 363LF0000X , with the licence number:  AP30004765 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: RN00077134 . This is a "RN LICENSE NUMBER" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: AP30004765 . This is a "AP LICENSE NUMBER" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




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