1467933267 NPI number — RESCUE 1 GLOBAL

Table of content: LAUREN MICHELLE PARKER CIT (NPI 1194363374)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467933267 NPI number — RESCUE 1 GLOBAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RESCUE 1 GLOBAL
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:
1467933267
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/28/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6688 NOLENSVILLE ROAD
Provider Second Line Business Mailing Address:
SUITE 108/167
Provider Business Mailing Address City Name:
BRENTWOOD
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37027
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:
6688 NOLENSVILLE ROAD
Provider Second Line Business Practice Location Address:
SUITE 108/167
Provider Business Practice Location Address City Name:
BRENTWOOD
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37027
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-348-7273
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/28/2018

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
WALSER
Authorized Official First Name:
ELIZABETH
Authorized Official Middle Name:
ANN
Authorized Official Title or Position:
DIRECTOR OF THERAPY AND PROGRAMMING
Authorized Official Telephone Number:
252-287-9198

Provider Taxonomy Codes

  • Taxonomy code: 261QM0855X , with the licence number:  I000000022237 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 00000 . This is a "NO PROVIDER IDENTIFIERS YET" identifier . This identifiers is of the category "OTHER".