1538161153 NPI number — MRS. JULIE H KENDALL OT

Table of content: MRS. JULIE H KENDALL OT (NPI 1538161153)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538161153 NPI number — MRS. JULIE H KENDALL OT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KENDALL
Provider First Name:
JULIE
Provider Middle Name:
H
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
OT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HILLERMAN
Provider Other First Name:
JULIE
Provider Other Middle Name:
E.
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1538161153
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/10/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1201 BLEACHERY BLVD
Provider Second Line Business Mailing Address:
SUITE # 201
Provider Business Mailing Address City Name:
ASHEVILLE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28803-8314
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-277-5763
Provider Business Mailing Address Fax Number:
828-577-5764

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1201 BLEACHERY BLVD
Provider Second Line Business Practice Location Address:
SUITE # 201
Provider Business Practice Location Address City Name:
ASHEVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28803-8314
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-277-5763
Provider Business Practice Location Address Fax Number:
828-277-5764
Provider Enumeration Date:
08/12/2005

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: 225X00000X , with the licence number:  3625 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 7301697 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com