1538474853 NPI number — SUSAN ELEANOR LIMBER SUSAN LIMBER

Table of content: SUSAN ELEANOR LIMBER SUSAN LIMBER (NPI 1538474853)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538474853 NPI number — SUSAN ELEANOR LIMBER SUSAN LIMBER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LIMBER
Provider First Name:
SUSAN
Provider Middle Name:
ELEANOR
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
SUSAN LIMBER
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LIMBER
Provider Other First Name:
SUSAN
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
RN, BSN, CLNC, CM
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1538474853
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/11/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8868 LAKEWOOD DRIVE
Provider Second Line Business Mailing Address:
# 317
Provider Business Mailing Address City Name:
WINDSOR
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95492-8010
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
707-499-5213
Provider Business Mailing Address Fax Number:
707-620-0663

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8868 LAKEWOOD DRIVE
Provider Second Line Business Practice Location Address:
# 317
Provider Business Practice Location Address City Name:
WINDSOR
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95492-8010
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
707-499-5213
Provider Business Practice Location Address Fax Number:
707-620-0663
Provider Enumeration Date:
08/11/2010

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: 163WC0400X , with the licence number:  550199 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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