NPI Code Detail JSON Logo

1114270089 NPI number — DELANA RAE CUDD RPH

NPI Number: 1114270089
Health Care Provider/Practitioner: DELANA RAE CUDD RPH

Information about “1114270089” NPI (DELANA RAE CUDD RPH) exists in 1114270089 in HTML format HTML  |  1114270089 in plain Text format TXT  |  1114270089 in PDF (Portable Document Format) PDF  |  1114270089 in an XML format XML  formats.

NPI Number : 1114270089 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1114270089",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "CUDD",
    "FirstName": "DELANA",
    "MiddleName": "RAE",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "RPH",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "GREEN",
    "OtherFirstName": "DELANA",
    "OtherMiddleName": "RAE",
    "OtherNamePrefix": "MS.",
    "OtherNameSuffix": null,
    "OtherCredential": "RPH",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "2219 MAIN ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CONWAY",
    "MailingAddressStateName": "SC",
    "MailingAddressPostalCode": "29526-3340",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "843-488-4400",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "2219 MAIN ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "CONWAY",
    "PracticeLocationAddressStateName": "SC",
    "PracticeLocationAddressPostalCode": "29526-3340",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "843-488-4400",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "10/17/2012",
    "LastUpdateDate": "10/10/2024",
    "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": "183500000X",
          "TaxonomyName": "Pharmacist",
          "LicenseNumber": "8985",
          "LicenseNumberStateCode": "TN",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "183500000X",
          "TaxonomyName": "Pharmacist",
          "LicenseNumber": "12418",
          "LicenseNumberStateCode": "SC",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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