1609964014 NPI number — MS. LORRAINE STAMPLE FINKBEINER CPNP

Table of content: MS. LORRAINE STAMPLE FINKBEINER CPNP (NPI 1609964014)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609964014 NPI number — MS. LORRAINE STAMPLE FINKBEINER CPNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FINKBEINER
Provider First Name:
LORRAINE
Provider Middle Name:
STAMPLE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
CPNP
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:
1609964014
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:
901 VERANO CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
VIRGINIA BEACH
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23456
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
757-426-1088
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
830 SOUTHAMPTON AVE
Provider Second Line Business Practice Location Address:
TIDEWATER CHILD DEVELOPMENT CLINIC
Provider Business Practice Location Address City Name:
NORFOLK
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23510
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-683-8770
Provider Business Practice Location Address Fax Number:
757-683-9211
Provider Enumeration Date:
10/11/2006

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: 363L00000X , with the licence number:  0024000061 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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