1699980375 NPI number — MRS. LYDIA STARNS HOOGE MS, LDN, RD

Table of content: (NPI 1295369841)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699980375 NPI number — MRS. LYDIA STARNS HOOGE MS, LDN, RD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOOGE
Provider First Name:
LYDIA
Provider Middle Name:
STARNS
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MS, LDN, RD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
STARNS
Provider Other First Name:
LYDIA
Provider Other Middle Name:
MARIE
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:
1699980375
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/09/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12670 SIMMS RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DENHAM SPRINGS
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70706-0462
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
225-387-7678
Provider Business Mailing Address Fax Number:
225-387-7670

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12670 SIMMS RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DENHAM SPRINGS
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70706-0462
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
225-387-7678
Provider Business Practice Location Address Fax Number:
225-387-7670
Provider Enumeration Date:
05/14/2007

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: 133V00000X , with the licence number:  1878 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 930875 . This is a "CDR ID #" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".
  • Identifier: 1878 . This is a "LDN #" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".




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