1730487695 NPI number — MRS. BETTY JEAN SCHWAB NURSE PRACTITIONER

Table of content: MRS. BETTY JEAN SCHWAB NURSE PRACTITIONER (NPI 1730487695)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730487695 NPI number — MRS. BETTY JEAN SCHWAB NURSE PRACTITIONER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHWAB
Provider First Name:
BETTY
Provider Middle Name:
JEAN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
NURSE PRACTITIONER
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:
1730487695
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/30/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7493 US HIGHWAY 278 E
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CULLMAN
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35055-7975
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
256-796-4299
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1201 7TH ST SE
Provider Second Line Business Practice Location Address:
DECATUR GENERAL HOSPITAL
Provider Business Practice Location Address City Name:
DECATUR
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35601
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
256-341-2000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/02/2011

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: 363LF0000X , with the licence number:  1-109629 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363L00000X , with the licence number: 1-109629 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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