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1023103090 NPI number — JULIE FAE WATTS APRN

NPI Number: 1023103090
Health Care Provider/Practitioner: JULIE FAE WATTS APRN

Information about “1023103090” NPI (JULIE FAE WATTS APRN) exists in 1023103090 in HTML format HTML  |  1023103090 in plain Text format TXT  |  1023103090 in PDF (Portable Document Format) PDF  |  1023103090 in an XML format XML  formats.

NPI Number : 1023103090 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1023103090",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "WATTS",
    "FirstName": "JULIE",
    "MiddleName": "FAE",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "APRN",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "CRARY",
    "OtherFirstName": "JULIE",
    "OtherMiddleName": "FAE",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "APRN",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "899 E 6TH ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CHADRON",
    "MailingAddressStateName": "NE",
    "MailingAddressPostalCode": "69337-2711",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "308-432-2513",
    "MailingAddressFaxNumber": "605-745-2890",
    "FirstLinePracticeLocationAddress": "500 N 5TH ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "HOT SPRINGS",
    "PracticeLocationAddressStateName": "SD",
    "PracticeLocationAddressPostalCode": "57747-1480",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "800-764-5370",
    "PracticeLocationAddressFaxNumber": "605-745-2890",
    "EnumerationDate": "10/04/2006",
    "LastUpdateDate": "07/08/2013",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "363LF0000X",
        "TaxonomyName": "Family Nurse Practitioner",
        "LicenseNumber": "110329",
        "LicenseNumberStateCode": "NE",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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