1427189570 NPI number — ST. JOHNS HOSPICE OF MISSISSIPPI, INC.

Table of content: EVELYN OLUOHA DNP, FNP (NPI 1477393098)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427189570 NPI number — ST. JOHNS HOSPICE OF MISSISSIPPI, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ST. JOHNS HOSPICE OF MISSISSIPPI, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1427189570
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
106 RUBY AVENUE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RULEVILLE
Provider Business Mailing Address State Name:
MS
Provider Business Mailing Address Postal Code:
38771
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
106 RUBY AVENUE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RULEVILLE
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
38771
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
662-756-0928
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/08/2007

Additional Information

Authorized Official

Authorized Official Last Name:
JOHNSON
Authorized Official First Name:
CAROLYN
Authorized Official Middle Name:
S
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
662-756-0928

Provider Taxonomy Codes

  • Taxonomy code: 315D00000X ; 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