1982700142 NPI number — MRS. PATRICIA ANN SHIELDS R.N.

Table of content: MRS. PATRICIA ANN SHIELDS R.N. (NPI 1982700142)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982700142 NPI number — MRS. PATRICIA ANN SHIELDS R.N.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SHIELDS
Provider First Name:
PATRICIA
Provider Middle Name:
ANN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
R.N.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
JONES
Provider Other First Name:
PATRICIA
Provider Other Middle Name:
ANN
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
R.N.
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1982700142
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:
480 CENTRAL AVE
Provider Second Line Business Mailing Address:
NAVAL HEALTH CLINIC HAWAII
Provider Business Mailing Address City Name:
PEARL HARBOR
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96869-4908
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-471-1866
Provider Business Mailing Address Fax Number:
808-471-1855

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
480 CENTRAL AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PEARL HARBOR
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96869-4908
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-471-1866
Provider Business Practice Location Address Fax Number:
808-471-1855
Provider Enumeration Date:
09/15/2006

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: 163W00000X , with the licence number:  RN 33564 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 163W00000X , with the licence number: 441016 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





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