1831346402 NPI number — LINDY J VRANIAK MD

Table of content: LINDY J VRANIAK MD (NPI 1831346402)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831346402 NPI number — LINDY J VRANIAK MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VRANIAK
Provider First Name:
LINDY
Provider Middle Name:
J
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MCLANDRESS
Provider Other First Name:
LINDY
Provider Other Middle Name:
J
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1831346402
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/14/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1102 NE 4TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BEND
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97701
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
541-389-0450
Provider Business Mailing Address Fax Number:
541-389-9567

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1102 NE 4TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BEND
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-389-0450
Provider Business Practice Location Address Fax Number:
541-389-9567
Provider Enumeration Date:
08/26/2008

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: 207V00000X , with the licence number:  MD151239 , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 12142564 . This is a "CAQH ID" identifier , issued by the state of ( OR ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com