1841183639 NPI number — MR. KEVON FRANCIS CHARLES ATHLETIC TRAINER ATC

Table of content: MR. KEVON FRANCIS CHARLES ATHLETIC TRAINER ATC (NPI 1841183639)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841183639 NPI number — MR. KEVON FRANCIS CHARLES ATHLETIC TRAINER ATC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHARLES
Provider First Name:
KEVON
Provider Middle Name:
FRANCIS
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
ATHLETIC TRAINER ATC
Provider Gender Code:
M

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:
1841183639
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/30/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1316 W ESPLANADE AVE APT I
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KENNER
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70065-2708
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
504-201-5266
Provider Business Mailing Address Fax Number:
504-201-5266

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1221 S CLEARVIEW PKWY APT I
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JEFFERSON
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70121-1011
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
504-736-4800
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/30/2025

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: 2255A2300X , with the licence number:  343639 , registered in the state of LA ; 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