1508696824 NPI number — HOLLY KATHLEEN ADAMS IHP LEVEL 2

Table of content: HOLLY KATHLEEN ADAMS IHP LEVEL 2 (NPI 1508696824)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508696824 NPI number — HOLLY KATHLEEN ADAMS IHP LEVEL 2

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ADAMS
Provider First Name:
HOLLY
Provider Middle Name:
KATHLEEN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
IHP LEVEL 2
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:
1508696824
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/02/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1522
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CAROLINA BEACH
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28428-1522
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-456-7750
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
705B THIRD EXT S
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KURE BEACH
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28449-3507
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-456-7750
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/02/2024

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: 171400000X ; 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