1356461552 NPI number — MISS JENNIFER LEIGH STOEBEL RN

Table of content: MISS JENNIFER LEIGH STOEBEL RN (NPI 1356461552)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356461552 NPI number — MISS JENNIFER LEIGH STOEBEL RN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STOEBEL
Provider First Name:
JENNIFER
Provider Middle Name:
LEIGH
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
RN
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:
1356461552
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/09/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
121 NORTH ST
Provider Second Line Business Mailing Address:
APT 7
Provider Business Mailing Address City Name:
MEDFIELD
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02052-1656
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
503-333-6117
Provider Business Mailing Address Fax Number:
508-359-1188

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7 CRESSBROOK
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORFOLK
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02056-1312
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-520-1582
Provider Business Practice Location Address Fax Number:
508-520-1582
Provider Enumeration Date:
03/30/2007

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: 163W00000X , with the licence number:  250496 , registered in the state of MA ; 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