1619062437 NPI number — MS. KYRA KILMER NP

Table of content: JOSEF BECHER PT, DPT (NPI 1700692241)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619062437 NPI number — MS. KYRA KILMER NP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KILMER
Provider First Name:
KYRA
Provider Middle Name:
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
NP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BASS/TURNER
Provider Other First Name:
KYRA
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1619062437
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/19/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 400
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RED BLUFF
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
96080-0400
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
530-527-0350
Provider Business Mailing Address Fax Number:
530-529-3881

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
TEHAMA COUNTY HEALTH SERVICES CLINIC DIVISON
Provider Second Line Business Practice Location Address:
1850 WALNUT ST SUITE E
Provider Business Practice Location Address City Name:
RED BLUFF
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
96080
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-527-0350
Provider Business Practice Location Address Fax Number:
530-529-3881
Provider Enumeration Date:
10/04/2006

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:  RN2259875 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: RN2259875 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: NP95004283 , 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)