1487919569 NPI number — ANNETTE IRENE ARMSTRONG LVN

Table of content: ANNETTE IRENE ARMSTRONG LVN (NPI 1487919569)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487919569 NPI number — ANNETTE IRENE ARMSTRONG LVN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ARMSTRONG
Provider First Name:
ANNETTE
Provider Middle Name:
IRENE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LVN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ARMSTRONG-BREWSTER
Provider Other First Name:
ANNETTE
Provider Other Middle Name:
IRENE
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
LVN
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1487919569
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/05/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 528
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SUTTER
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95982-0528
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
530-844-1747
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8388 MARSHALL STREET
Provider Second Line Business Practice Location Address:
NO MAIL RECEPTACLE/PLEASE USE PO BOX FOR SAFE DELIVERY
Provider Business Practice Location Address City Name:
SUTTER
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95982
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-674-7665
Provider Business Practice Location Address Fax Number:
530-674-7665
Provider Enumeration Date:
07/05/2012

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: 164W00000X , with the licence number:  VN157409 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: VN157409 . This is a "LICENSED VOCATIONAL NURSE/BVNPT BOARD ISSUED LICENSE NUMBER" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".