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1073112066 NPI number — COURTNEY JEFFUS FNP

NPI Number: 1073112066
Health Care Provider/Practitioner: COURTNEY JEFFUS FNP

Information about “1073112066” NPI (COURTNEY JEFFUS FNP) exists in 1073112066 in HTML format HTML  |  1073112066 in plain Text format TXT  |  1073112066 in PDF (Portable Document Format) PDF  |  1073112066 in an XML format XML  formats.

NPI Number : 1073112066 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1073112066",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "JEFFUS",
    "FirstName": "COURTNEY",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "FNP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "SAVAGE",
    "OtherFirstName": "COURTNEY",
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "5127 OLDENBURG RD NW",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "ROXIE",
    "MailingAddressStateName": "MS",
    "MailingAddressPostalCode": "39661-6076",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "601-597-5308",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "54 SGT PRENTISS DR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "NATCHEZ",
    "PracticeLocationAddressStateName": "MS",
    "PracticeLocationAddressPostalCode": "39120-4726",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "601-443-2680",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "10/20/2020",
    "LastUpdateDate": "10/20/2020",
    "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": "904224",
        "LicenseNumberStateCode": "MS",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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