1467639427 NPI number — MRS. KENDALL SKELTON WELDER C.R.N.P., R.N.

Table of content: MRS. KENDALL SKELTON WELDER C.R.N.P., R.N. (NPI 1467639427)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467639427 NPI number — MRS. KENDALL SKELTON WELDER C.R.N.P., R.N.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WELDER
Provider First Name:
KENDALL
Provider Middle Name:
SKELTON
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
C.R.N.P., R.N.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SKELTON
Provider Other First Name:
KENDALL
Provider Other Middle Name:
KATHLEEN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
CRNP, R.N.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1467639427
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/04/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
829 RIVERBEND DRIVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GADSDEN
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35901
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
256-546-6241
Provider Business Mailing Address Fax Number:
256-546-2214

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
829 RIVERBEND DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GADSDEN
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35901
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
256-546-4611
Provider Business Practice Location Address Fax Number:
256-546-2214
Provider Enumeration Date:
01/22/2008

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:  1-103188 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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