1881844595 NPI number — MISS VALARIE LYNN HARBAUGH CRNP

Table of content: MISS VALARIE LYNN HARBAUGH CRNP (NPI 1881844595)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881844595 NPI number — MISS VALARIE LYNN HARBAUGH CRNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HARBAUGH
Provider First Name:
VALARIE
Provider Middle Name:
LYNN
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
CRNP
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:
1881844595
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/28/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
20410 OBSERVATION DR
Provider Second Line Business Mailing Address:
STE 100
Provider Business Mailing Address City Name:
GERMANTOWN
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20876-6419
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-328-2302
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
20410 OBSERVATION DR
Provider Second Line Business Practice Location Address:
STE 100
Provider Business Practice Location Address City Name:
GERMANTOWN
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20876-6419
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-956-2470
Provider Business Practice Location Address Fax Number:
301-330-9108
Provider Enumeration Date:
09/30/2008

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: 363LA2100X , with the licence number:  N65150 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: S062-0501 . This is a "CAREFIRST" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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