1891832002 NPI number — MRS. CHARLENE B STAMPS CRNA

Table of content: MRS. CHARLENE B STAMPS CRNA (NPI 1891832002)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891832002 NPI number — MRS. CHARLENE B STAMPS CRNA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STAMPS
Provider First Name:
CHARLENE
Provider Middle Name:
B
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
CRNA
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:
1891832002
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4417 S TONTI ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW ORLEANS
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70125-4453
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
504-821-2293
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
ST. CHARLES PARISH HOSPITAL
Provider Second Line Business Practice Location Address:
1057 PAUL MAILLARD RD.
Provider Business Practice Location Address City Name:
LULING
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70070
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
985-785-6242
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/30/2007

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: 367500000X , 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)

  • Identifier: 1391140 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com