1376723148 NPI number — MRS. REBECCA ELON EVERETT ESPEY N.P.

Table of content: MRS. REBECCA ELON EVERETT ESPEY N.P. (NPI 1376723148)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376723148 NPI number — MRS. REBECCA ELON EVERETT ESPEY N.P.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ESPEY
Provider First Name:
REBECCA
Provider Middle Name:
ELON EVERETT
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
N.P.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ESPEY
Provider Other First Name:
ELON
Provider Other Middle Name:
EVERETT
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
N.P.
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1376723148
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/09/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
700 NORTHSIDE DRIVE
Provider Second Line Business Mailing Address:
P.O. BOX 470
Provider Business Mailing Address City Name:
NEWTON
Provider Business Mailing Address State Name:
MS
Provider Business Mailing Address Postal Code:
39345-0470
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
601-683-4300
Provider Business Mailing Address Fax Number:
601-683-4303

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
701 NORTHSIDE DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEWTON
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
39345-0470
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
601-683-4300
Provider Business Practice Location Address Fax Number:
601-683-4303
Provider Enumeration Date:
11/09/2007

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: 363LF0000X , with the licence number:  R850861 , registered in the state of MS ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LP0808X , with the licence number: R850861 , registered in the state of MS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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