1962724302 NPI number — MRS. JENNIFER C STRAUB RN,CNOR,RNFA

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962724302 NPI number — MRS. JENNIFER C STRAUB RN,CNOR,RNFA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STRAUB
Provider First Name:
JENNIFER
Provider Middle Name:
C
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
RN,CNOR,RNFA
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:
1962724302
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/24/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2085 HIGHWAY A1A
Provider Second Line Business Mailing Address:
UNIT 3702
Provider Business Mailing Address City Name:
INDIAN HARBOUR BEACH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32937-1801
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
321-610-4332
Provider Business Mailing Address Fax Number:
321-610-4332

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2085 HIGHWAY A1A
Provider Second Line Business Practice Location Address:
UNIT 3702
Provider Business Practice Location Address City Name:
INDIAN HARBOUR BEACH
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32937-1801
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
321-610-4332
Provider Business Practice Location Address Fax Number:
321-610-4332
Provider Enumeration Date:
02/26/2010

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: 163WR0006X , with the licence number:  RN9258238 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 163WR0006X , with the licence number: 563471 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





Copyright © 2007-2025 www.npivalidator.com