1467583732 NPI number — MRS. MARGARET P BROWN RN

Table of content: BARBARA M TAKACS CRNP (NPI 1174088272)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467583732 NPI number — MRS. MARGARET P BROWN RN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BROWN
Provider First Name:
MARGARET
Provider Middle Name:
P
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
RN
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:
1467583732
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/09/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
414 N HIGHLAND AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PIERRE
Provider Business Mailing Address State Name:
SD
Provider Business Mailing Address Postal Code:
57501-2119
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
605-224-1609
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
HWY 34 & 47
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FORT THOMPSON
Provider Business Practice Location Address State Name:
SD
Provider Business Practice Location Address Postal Code:
57339-0200
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
605-245-1504
Provider Business Practice Location Address Fax Number:
605-245-2384
Provider Enumeration Date:
03/08/2007

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: 163WC1500X , with the licence number:  R042713 , registered in the state of SD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: R042713 . This is a "STATE LICENSE NUMBER" identifier , issued by the state of ( SD ) . This identifiers is of the category "OTHER".
  • Identifier: 5549010 , issued by the state of ( SD ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com