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1033645049 NPI number — DONNA RACHAEL HORTON STUDENT

NPI Number: 1033645049
Health Care Provider/Practitioner: DONNA RACHAEL HORTON STUDENT

Information about “1033645049” NPI (DONNA RACHAEL HORTON STUDENT) exists in 1033645049 in HTML format HTML  |  1033645049 in plain Text format TXT  |  1033645049 in PDF (Portable Document Format) PDF  |  1033645049 in an XML format XML  formats.

NPI Number : 1033645049 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1033645049",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "HORTON",
    "FirstName": "DONNA",
    "MiddleName": "RACHAEL",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "STUDENT",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "BANET BEAL",
    "OtherFirstName": "DONNA",
    "OtherMiddleName": "RACHAEL",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "PO BOX 5299",
    "SecondLineMailingAddress": "MS: 820-5-PCO",
    "MailingAddressCityName": "TACOMA",
    "MailingAddressStateName": "WA",
    "MailingAddressPostalCode": "98415-0299",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "4748 BORGEN BLVD",
    "SecondLinePracticeLocationAddress": "STE G",
    "PracticeLocationAddressCityName": "GIG HARBOR",
    "PracticeLocationAddressStateName": "WA",
    "PracticeLocationAddressPostalCode": "98332-6764",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "253-530-8450",
    "PracticeLocationAddressFaxNumber": "253-530-8451",
    "EnumerationDate": "05/11/2017",
    "LastUpdateDate": "01/27/2026",
    "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": "363L00000X",
          "TaxonomyName": "Nurse Practitioner",
          "LicenseNumber": "AP60767026",
          "LicenseNumberStateCode": "WA",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "363LF0000X",
          "TaxonomyName": "Family Nurse Practitioner",
          "LicenseNumber": "AP60767026",
          "LicenseNumberStateCode": "WA",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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