1720089238 NPI number — ROSALIND C KLINEPETER CNM

Table of content: ROSALIND C KLINEPETER CNM (NPI 1720089238)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720089238 NPI number — ROSALIND C KLINEPETER CNM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KLINEPETER
Provider First Name:
ROSALIND
Provider Middle Name:
C
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CNM
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:
1720089238
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/24/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
386 STRAWBERRY LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BIG COVE TANNERY
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17212-9425
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
386 STRAWBERRY LN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BIG COVE TANNERY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17212-9425
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-816-6914
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/09/2005

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: 163W00000X , with the licence number:  RN176944L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 176B00000X , with the licence number: MW008573L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 367A00000X , with the licence number: MW008573L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 867633 . This is a "GROUP MEDICARE #" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 001799570 0003 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 25-1716306 . This is a "HEALTHNET/TRICARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 50010206 . This is a "CAPITAL BLUECROSS (POTOMAC)" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: MW008573L . This is a "LICENSE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 148683 . This is a "HIGHMARK BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1720089238 . This is a "FIRST HEALTH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 384256 . This is a "HEALTH AMERICA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 50087600 . This is a "CAPITAL BLUECROSS (COUNTRY CARE)" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 138126 . This is a "UNISON (POTOMAC)" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 25-1716306 . This is a "INTERGROUP" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 25-1716306 . This is a "MULTIPLAN/PHCS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 420001728 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 6883355 . This is a "AETNA HMO (POTOMAC)" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 25-1716306 . This is a "INFORMED" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 867633 . This is a "MEDICARE GROUP #" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 9278320 . This is a "AETNA NON-HMO (POTOMAC)" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: S54700001/D8NOCO . This is a "CAREFIRST (COUNTRY CARE)" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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