NPI Code Detail JSON Logo

1104327766 NPI number — MAKKEL MARIE ANDREAN DA.C, ATC

NPI Number: 1104327766
Health Care Provider/Practitioner: MAKKEL MARIE ANDREAN DA.C, ATC

Information about “1104327766” NPI (MAKKEL MARIE ANDREAN DA.C, ATC) exists in 1104327766 in HTML format HTML  |  1104327766 in plain Text format TXT  |  1104327766 in PDF (Portable Document Format) PDF  |  1104327766 in an XML format XML  formats.

NPI Number : 1104327766 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1104327766",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "ANDREAN",
    "FirstName": "MAKKEL",
    "MiddleName": "MARIE",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "DA.C, ATC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1260 E 1ST PL",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "MESA",
    "MailingAddressStateName": "AZ",
    "MailingAddressPostalCode": "85203-8920",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "480-620-8798",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "2915 E BASELINE RD STE 126",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "GILBERT",
    "PracticeLocationAddressStateName": "AZ",
    "PracticeLocationAddressPostalCode": "85234-2475",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "480-620-8798",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "02/27/2018",
    "LastUpdateDate": "01/12/2024",
    "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": "2255A2300X",
          "TaxonomyName": "Athletic Trainer",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "171100000X",
          "TaxonomyName": "Acupuncturist",
          "LicenseNumber": "011995",
          "LicenseNumberStateCode": "AZ",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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