1790862217 NPI number — MRS. LORRAINE TAYLOR RILKO FNP

Table of content: MRS. LORRAINE TAYLOR RILKO FNP (NPI 1790862217)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790862217 NPI number — MRS. LORRAINE TAYLOR RILKO FNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RILKO
Provider First Name:
LORRAINE
Provider Middle Name:
TAYLOR
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
FNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
TAYLOR
Provider Other First Name:
LORRAINE
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
NP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1790862217
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/06/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 79777
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BALTIMORE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21279-0777
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
434-654-7794
Provider Business Mailing Address Fax Number:
434-654-4555

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
310 OLD IVY WAY STE 201
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHARLOTTESVILLE
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22903
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
434-654-4550
Provider Business Practice Location Address Fax Number:
434-654-4555
Provider Enumeration Date:
11/01/2006

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: 363LF0000X , with the licence number:  0024094271 , 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)





Copyright © 2007-2025 www.npivalidator.com