1477042265 NPI number — MRS. CARYN ELIZABETH WHISLER BSL

Table of content: MRS. CARYN ELIZABETH WHISLER BSL (NPI 1477042265)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477042265 NPI number — MRS. CARYN ELIZABETH WHISLER BSL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WHISLER
Provider First Name:
CARYN
Provider Middle Name:
ELIZABETH
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
BSL
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WHITE
Provider Other First Name:
CARYN
Provider Other Middle Name:
ELIZABETH
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1477042265
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/07/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
603 LAMBORN RIDGE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WEST GROVE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19390-1367
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
484-942-5931
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
410 N PRINCE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LANCASTER
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17603-3010
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-560-7917
Provider Business Practice Location Address Fax Number:
717-560-6452
Provider Enumeration Date:
05/07/2018

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: 103K00000X , with the licence number:  BH003777 ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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