1447829585 NPI number — GUINEVERE ARTHUR VANHORNE PA-C

Table of content: DANIELLE RATLIFF (NPI 1902694748)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447829585 NPI number — GUINEVERE ARTHUR VANHORNE PA-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VANHORNE
Provider First Name:
GUINEVERE ARTHUR
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PA-C
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:
1447829585
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/23/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 WHITE LOAF RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SOUTHAMPTON
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01073-9550
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
413-333-7295
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
470 GRANBY RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SOUTH HADLEY
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01075-3218
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
413-533-3926
Provider Business Practice Location Address Fax Number:
413-794-8732
Provider Enumeration Date:
06/23/2021

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: 207RC0000X , with the licence number:  PA8192 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363A00000X , with the licence number: PA8192 , 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)





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