1558640482 NPI number — MRS. VERSHAY LAY'ETTE TRAMMER PRACTICAL NURSE

Table of content: MRS. VERSHAY LAY'ETTE TRAMMER PRACTICAL NURSE (NPI 1558640482)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558640482 NPI number — MRS. VERSHAY LAY'ETTE TRAMMER PRACTICAL NURSE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TRAMMER
Provider First Name:
VERSHAY
Provider Middle Name:
LAY'ETTE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
PRACTICAL NURSE
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HUNTER
Provider Other First Name:
VERSHAY
Provider Other Middle Name:
LAY'ETTE
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:
1558640482
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/09/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
25000 ROCKSIDE RD
Provider Second Line Business Mailing Address:
APARTMENT 207
Provider Business Mailing Address City Name:
BEDFORD HEIGHTS
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44146-1937
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
216-630-8325
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
25000 ROCKSIDE RD
Provider Second Line Business Practice Location Address:
APARTMENT 207
Provider Business Practice Location Address City Name:
BEDFORD HEIGHTS
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44146-1937
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
216-630-8325
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/09/2011

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: 164W00000X , with the licence number:  PN140011 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2024 www.npivalidator.com