1518938703 NPI number — CATHY HOBBS BARTLEY C.P.N.P.

Table of content: CATHY HOBBS BARTLEY C.P.N.P. (NPI 1518938703)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518938703 NPI number — CATHY HOBBS BARTLEY C.P.N.P.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BARTLEY
Provider First Name:
CATHY
Provider Middle Name:
HOBBS
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
C.P.N.P.
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:
1518938703
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/13/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 8500
Provider Second Line Business Mailing Address:
LOCKBOX #7642
Provider Business Mailing Address City Name:
PHILADELPHIA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19178-7642
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
813-281-8478
Provider Business Mailing Address Fax Number:
813-281-8113

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3100 SAMFORD AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SHREVEPORT
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
71103-4239
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
318-226-3306
Provider Business Practice Location Address Fax Number:
318-226-3319
Provider Enumeration Date:
01/27/2006

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: 363L00000X , with the licence number:  AP03503 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363L00000X , with the licence number: R0084201 , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: RN073845 . This is a "REGISTERED NURSE" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".
  • Identifier: AP03503 . This is a "ADVANCED PRACTICE" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".




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