1578788493 NPI number — MRS. TRICIA LYNN MESSENGER PTA

Table of content: MRS. TRICIA LYNN MESSENGER PTA (NPI 1578788493)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578788493 NPI number — MRS. TRICIA LYNN MESSENGER PTA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MESSENGER
Provider First Name:
TRICIA
Provider Middle Name:
LYNN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
PTA
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:
1578788493
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2524 SO 9TH STREET
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
IRONTON
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45638
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
740-533-9542
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
813 & ONE HALF MARIAN PIKE
Provider Second Line Business Practice Location Address:
SUNSET NURSING FACILITY
Provider Business Practice Location Address City Name:
IRONTON
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45638
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
740-532-0449
Provider Business Practice Location Address Fax Number:
740-534-0586
Provider Enumeration Date:
04/16/2007

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: 225200000X , with the licence number:  PTA02381 ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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