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1114257037 NPI number — MS. KATHLEEN SQUIRES

NPI Number: 1114257037
Health Care Provider/Practitioner: MS. KATHLEEN SQUIRES

Information about “1114257037” NPI (MS. KATHLEEN SQUIRES) exists in 1114257037 in HTML format HTML  |  1114257037 in plain Text format TXT  |  1114257037 in PDF (Portable Document Format) PDF  |  1114257037 in an XML format XML  formats.

NPI Number : 1114257037 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1114257037",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "SQUIRES",
    "FirstName": "KATHLEEN",
    "MiddleName": null,
    "NamePrefix": "MS.",
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "SQUIRES",
    "OtherFirstName": "KATHLEEN",
    "OtherMiddleName": null,
    "OtherNamePrefix": "MS.",
    "OtherNameSuffix": null,
    "OtherCredential": "R.D.",
    "OtherLastNameTypeCode": "2",
    "FirstLineMailingAddress": "50 NICHOLS RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "NEWFANE",
    "MailingAddressStateName": "VT",
    "MailingAddressPostalCode": "05345",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "802-365-7388",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "50 NICHOLS RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "NEWFANE",
    "PracticeLocationAddressStateName": "VT",
    "PracticeLocationAddressPostalCode": "05345-9594",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "802-365-7388",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "12/29/2009",
    "LastUpdateDate": "12/29/2009",
    "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": "133V00000X",
        "TaxonomyName": "Registered Dietitian",
        "LicenseNumber": "074000145",
        "LicenseNumberStateCode": "VT",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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