1942218458 NPI number — MRS. JANICE PURGASON WHICKER MED

Table of content: MRS. JANICE PURGASON WHICKER MED (NPI 1942218458)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942218458 NPI number — MRS. JANICE PURGASON WHICKER MED

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WHICKER
Provider First Name:
JANICE
Provider Middle Name:
PURGASON
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MED
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:
1942218458
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:
PO BOX 3721
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HICKORY
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28603
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-328-2966
Provider Business Mailing Address Fax Number:
828-328-3336

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
34 2ND ST NW
Provider Second Line Business Practice Location Address:
SUITE 304
Provider Business Practice Location Address City Name:
HICKORY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28601
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-328-2966
Provider Business Practice Location Address Fax Number:
828-328-3336
Provider Enumeration Date:
08/03/2006

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: 106H00000X , with the licence number:  384 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 133KG . This is a "BCBS NC" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 6105118 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com