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1114455565 NPI number — LORI EBARB REEVES NP

NPI Number: 1114455565
Health Care Provider/Practitioner: LORI EBARB REEVES NP

Information about “1114455565” NPI (LORI EBARB REEVES NP) exists in 1114455565 in HTML format HTML  |  1114455565 in plain Text format TXT  |  1114455565 in PDF (Portable Document Format) PDF  |  1114455565 in an XML format XML  formats.

NPI Number : 1114455565 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1114455565",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "REEVES",
    "FirstName": "LORI",
    "MiddleName": "EBARB",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "NP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "457 PRIVATE ROAD 1141",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "WASKOM",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "75692-4828",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "903-742-5777",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "2901 4TH ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LONGVIEW",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "75605-5128",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "903-233-4795",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "05/30/2017",
    "LastUpdateDate": "05/30/2017",
    "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": "AP133494",
        "LicenseNumberStateCode": "TX",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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