NPI Code Detail JSON Logo

1023690989 NPI number — DEIRDRE LEE BRELAND NP

NPI Number: 1023690989
Health Care Provider/Practitioner: DEIRDRE LEE BRELAND NP

Information about “1023690989” NPI (DEIRDRE LEE BRELAND NP) exists in 1023690989 in HTML format HTML  |  1023690989 in plain Text format TXT  |  1023690989 in PDF (Portable Document Format) PDF  |  1023690989 in an XML format XML  formats.

NPI Number : 1023690989 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1023690989",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BRELAND",
    "FirstName": "DEIRDRE",
    "MiddleName": "LEE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "NP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "PO BOX 1089",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "HAMMOND",
    "MailingAddressStateName": "LA",
    "MailingAddressPostalCode": "70404-1089",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "995-892-7070",
    "MailingAddressFaxNumber": "985-892-7017",
    "FirstLinePracticeLocationAddress": "1302 44TH AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "GULFPORT",
    "PracticeLocationAddressStateName": "MS",
    "PracticeLocationAddressPostalCode": "39501-2552",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "228-687-8235",
    "PracticeLocationAddressFaxNumber": "228-206-6470",
    "EnumerationDate": "04/21/2021",
    "LastUpdateDate": "04/11/2023",
    "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": "904579",
        "LicenseNumberStateCode": "MS",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.