1497955389 NPI number — MISS ASHLEY ELIZABETH MUSSER MT-BC

Table of content: MISS ASHLEY ELIZABETH MUSSER MT-BC (NPI 1497955389)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497955389 NPI number — MISS ASHLEY ELIZABETH MUSSER MT-BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MUSSER
Provider First Name:
ASHLEY
Provider Middle Name:
ELIZABETH
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
MT-BC
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:
1497955389
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/19/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2009 WESSEL CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ST CHARLES
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60174-3559
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
989-600-2987
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
40 W 310 LAFOX ROAD
Provider Second Line Business Practice Location Address:
B1
Provider Business Practice Location Address City Name:
ST. CHARLES
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60175-6588
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
630-444-0077
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/19/2007

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: 174400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com