1538334131 NPI number — KRISTEN J KAUFMAN AUD

Table of content: KRISTEN J KAUFMAN AUD (NPI 1538334131)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538334131 NPI number — KRISTEN J KAUFMAN AUD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KAUFMAN
Provider First Name:
KRISTEN
Provider Middle Name:
J
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
AUD
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:
1538334131
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/05/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5124 S WESTERN AVE
Provider Second Line Business Mailing Address:
SUITE 4
Provider Business Mailing Address City Name:
SIOUX FALLS
Provider Business Mailing Address State Name:
SD
Provider Business Mailing Address Postal Code:
57108-5047
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
605-275-5545
Provider Business Mailing Address Fax Number:
605-275-5546

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5124 S WESTERN AVE
Provider Second Line Business Practice Location Address:
SUITE 4
Provider Business Practice Location Address City Name:
SIOUX FALLS
Provider Business Practice Location Address State Name:
SD
Provider Business Practice Location Address Postal Code:
57108-5047
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
605-275-5545
Provider Business Practice Location Address Fax Number:
605-275-5546
Provider Enumeration Date:
04/24/2008

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: 237600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 16 . This is a "SD BOARD OF HEARING AID DISPENSERS AND AUDIOLOGISTS" identifier , issued by the state of ( SD ) . This identifiers is of the category "OTHER".




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