NPI Code Detail JSON Logo

1023886637 NPI number — STEFFANIE MICHELLE MACK PMHNP-BC

NPI Number: 1023886637
Health Care Provider/Practitioner: STEFFANIE MICHELLE MACK PMHNP-BC

Information about “1023886637” NPI (STEFFANIE MICHELLE MACK PMHNP-BC) exists in 1023886637 in HTML format HTML  |  1023886637 in plain Text format TXT  |  1023886637 in PDF (Portable Document Format) PDF  |  1023886637 in an XML format XML  formats.

NPI Number : 1023886637 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1023886637",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MACK",
    "FirstName": "STEFFANIE",
    "MiddleName": "MICHELLE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "PMHNP-BC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1680 HENDERSONVILLE RD APT H08",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "ASHEVILLE",
    "MailingAddressStateName": "NC",
    "MailingAddressPostalCode": "28803-3227",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "912-695-4834",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "101 CABARRUS AVE E STE 200",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "CONCORD",
    "PracticeLocationAddressStateName": "NC",
    "PracticeLocationAddressPostalCode": "28025-3781",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "912-695-4834",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "12/13/2023",
    "LastUpdateDate": "12/13/2023",
    "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": "363LP0808X",
        "TaxonomyName": "Psychiatric/Mental Health Nurse Practitioner",
        "LicenseNumber": "5019274",
        "LicenseNumberStateCode": "NC",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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