1942634985 NPI number — REBEKAH TURNER REDDEL APRN, LLC

Table of content: (NPI 1942634985)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942634985 NPI number — REBEKAH TURNER REDDEL APRN, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
REBEKAH TURNER REDDEL APRN, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1942634985
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/04/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
18 ROBIN HOOD DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LONDONDERRY
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03053-4021
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-930-6662
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
172 ROUTE 101
Provider Second Line Business Practice Location Address:
UNIT 26
Provider Business Practice Location Address City Name:
BEDFORD
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03110-5416
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-930-6662
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/27/2013

Additional Information

Authorized Official

Authorized Official Last Name:
REDDEL
Authorized Official First Name:
REBEKAH
Authorized Official Middle Name:
TURNER
Authorized Official Title or Position:
PSYCHIATRIC NURSE PRACTITIONER
Authorized Official Telephone Number:
603-930-6662

Provider Taxonomy Codes

  • Taxonomy code: 363LP0808X , with the licence number:  023022-23 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 023022-23 . This is a "NURSE PRACTITIONER LICENSE" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 30005503 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 11378324 . This is a "CAQH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1326007683 . This is a "NPI" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com