1902478795 NPI number — MR. ALECZANDER CLYDE BATTELLE CRNA

Table of content: MR. ALECZANDER CLYDE BATTELLE CRNA (NPI 1902478795)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902478795 NPI number — MR. ALECZANDER CLYDE BATTELLE CRNA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BATTELLE
Provider First Name:
ALECZANDER
Provider Middle Name:
CLYDE
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
CRNA
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:
1902478795
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/12/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
CMR 402 BOX 2304
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
APO
Provider Business Mailing Address State Name:
AE
Provider Business Mailing Address Postal Code:
09180-0024
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
920-840-8863
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
LANDSTUHL REGIONAL MEDICAL CENTER
Provider Second Line Business Practice Location Address:
U.S. HOSPITAL
Provider Business Practice Location Address City Name:
LANDSTUHL
Provider Business Practice Location Address State Name:
RHEINLAND-PFALZ
Provider Business Practice Location Address Postal Code:
66849
Provider Business Practice Location Address Country Code:
DE
Provider Business Practice Location Address Telephone Number:
63-719-4644
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/12/2021

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 , with the licence number:  AP61194029 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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