1811042187 NPI number — MS. KATHARINE COFFIN HULSE M.ED., ITDS

Table of content: MS. KATHARINE COFFIN HULSE M.ED., ITDS (NPI 1811042187)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811042187 NPI number — MS. KATHARINE COFFIN HULSE M.ED., ITDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HULSE
Provider First Name:
KATHARINE
Provider Middle Name:
COFFIN
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
M.ED., ITDS
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:
1811042187
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/09/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1534 SEFFNER VALRICO RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SEFFNER
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33584-6150
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
813-689-4315
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7402 N 56TH ST
Provider Second Line Business Practice Location Address:
SUITE 906
Provider Business Practice Location Address City Name:
TAMPA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33617-7733
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
813-988-7633
Provider Business Practice Location Address Fax Number:
813-914-0403
Provider Enumeration Date:
01/24/2007

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: 174400000X , with the licence number:  NONE ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 222Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

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





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