1750545281 NPI number — KATHYRN SCRIBNER NP

Table of content: KATHYRN SCRIBNER NP (NPI 1750545281)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750545281 NPI number — KATHYRN SCRIBNER NP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCRIBNER
Provider First Name:
KATHYRN
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
NP
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:
1750545281
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/10/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
44 MEDICAL PARK BLVD
Provider Second Line Business Mailing Address:
SUITE A
Provider Business Mailing Address City Name:
PETERSBURG
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23805-9349
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
804-324-4511
Provider Business Mailing Address Fax Number:
804-835-5103

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
44 MEDICAL PARK BLVD
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
PETERSBURG
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23805-9349
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
804-324-4511
Provider Business Practice Location Address Fax Number:
804-835-5103
Provider Enumeration Date:
07/14/2008

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: 363L00000X , with the licence number:  0024164803 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 331032738 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




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