1740388511 NPI number — CARMEN RENEE BROWNING PSC EARLY INTERVENT

Table of content: CARMEN RENEE BROWNING PSC EARLY INTERVENT (NPI 1740388511)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740388511 NPI number — CARMEN RENEE BROWNING PSC EARLY INTERVENT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BROWNING
Provider First Name:
CARMEN
Provider Middle Name:
RENEE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PSC EARLY INTERVENT
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:
1740388511
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1431
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
VERSAILLES
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40383-5431
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
859-420-7708
Provider Business Mailing Address Fax Number:
859-879-6165

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
111 MINARY AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
VERSAILLES
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40383-1329
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-420-7708
Provider Business Practice Location Address Fax Number:
859-879-6165
Provider Enumeration Date:
09/20/2006

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: 305S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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