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1104312644 NPI number — JESSICA MONIQUE GARCIA FNP

NPI Number: 1104312644
Health Care Provider/Practitioner: JESSICA MONIQUE GARCIA FNP

Information about “1104312644” NPI (JESSICA MONIQUE GARCIA FNP) exists in 1104312644 in HTML format HTML  |  1104312644 in plain Text format TXT  |  1104312644 in PDF (Portable Document Format) PDF  |  1104312644 in an XML format XML  formats.

NPI Number : 1104312644 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1104312644",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "GARCIA",
    "FirstName": "JESSICA",
    "MiddleName": "MONIQUE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "FNP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "JANSEN",
    "OtherFirstName": "JESSICA",
    "OtherMiddleName": "MONIQUE",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "6210 E HWY 290",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "AUSTIN",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "78723-1142",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "512-483-9596",
    "MailingAddressFaxNumber": "512-406-6216",
    "FirstLinePracticeLocationAddress": "3828 S 1ST ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "AUSTIN",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "78704-7048",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "512-443-1311",
    "PracticeLocationAddressFaxNumber": "512-406-6266",
    "EnumerationDate": "07/09/2018",
    "LastUpdateDate": "09/25/2024",
    "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": "363LF0000X",
        "TaxonomyName": "Family Nurse Practitioner",
        "LicenseNumber": "AP137922",
        "LicenseNumberStateCode": "TX",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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