Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
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NPI 1386617298

Individual provider · NPI 1386617298 Deactivated

This NPI was deactivated on October 22, 2026. The record is kept for reference and should not be used for billing or referrals.

NPI 1386617298 is listed in the national NPI registry.

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Record details

NPI number1386617298
Entity typeIndividual (Type 1)
NPI enumerated—
Last updated in NPPES—