1659658565 NPI number — ESTHER SUSAN PERSHING RN BSN CDE

Table of content: ESTHER SUSAN PERSHING RN BSN CDE (NPI 1659658565)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659658565 NPI number — ESTHER SUSAN PERSHING RN BSN CDE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PERSHING
Provider First Name:
ESTHER
Provider Middle Name:
SUSAN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
RN BSN CDE
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:
1659658565
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/05/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
17956 E BAILS PL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AURORA
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80017-5323
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
720-297-6385
Provider Business Mailing Address Fax Number:
866-853-2708

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
17956 E BAILS PL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AURORA
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80017-5323
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
720-297-6385
Provider Business Practice Location Address Fax Number:
866-853-2708
Provider Enumeration Date:
11/05/2011

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: 163WD0400X , with the licence number:  RN124349 , registered in the state of CO ; 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