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1083653869 NPI number — DIANE PAIGE LONG APRN

NPI Number: 1083653869
Health Care Provider/Practitioner: DIANE PAIGE LONG APRN

Information about “1083653869” NPI (DIANE PAIGE LONG APRN) exists in 1083653869 in HTML format HTML  |  1083653869 in plain Text format TXT  |  1083653869 in PDF (Portable Document Format) PDF  |  1083653869 in an XML format XML  formats.

NPI Number : 1083653869 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1083653869",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "LONG",
    "FirstName": "DIANE",
    "MiddleName": "PAIGE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "APRN",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "KRASNOPERO",
    "OtherFirstName": "DIANE",
    "OtherMiddleName": "PAIGE",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "APRN",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "601 5TH ST S",
    "SecondLineMailingAddress": "CARDIOLOGY",
    "MailingAddressCityName": "ST PETERSBURG",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "33701-4804",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "727-767-4954",
    "MailingAddressFaxNumber": "727-767-2880",
    "FirstLinePracticeLocationAddress": "1405 CLIFTON RD NE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "ATLANTA",
    "PracticeLocationAddressStateName": "GA",
    "PracticeLocationAddressPostalCode": "30322-4634",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "404-785-6395",
    "PracticeLocationAddressFaxNumber": "404-785-1994",
    "EnumerationDate": "06/06/2006",
    "LastUpdateDate": "07/19/2024",
    "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": "363LP0200X",
          "TaxonomyName": "Pediatric Nurse Practitioner",
          "LicenseNumber": "F381443",
          "LicenseNumberStateCode": "NY",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LP0200X",
          "TaxonomyName": "Pediatric Nurse Practitioner",
          "LicenseNumber": "ARNP 9246874",
          "LicenseNumberStateCode": "FL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LP0200X",
          "TaxonomyName": "Pediatric Nurse Practitioner",
          "LicenseNumber": "RN280201",
          "LicenseNumberStateCode": "GA",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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