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1114502366 NPI number — AUDREY MARIE REED MOBILE PHLEBOTOMIST

NPI Number: 1114502366
Health Care Provider/Practitioner: AUDREY MARIE REED MOBILE PHLEBOTOMIST

Information about “1114502366” NPI (AUDREY MARIE REED MOBILE PHLEBOTOMIST) exists in 1114502366 in HTML format HTML  |  1114502366 in plain Text format TXT  |  1114502366 in PDF (Portable Document Format) PDF  |  1114502366 in an XML format XML  formats.

NPI Number : 1114502366 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1114502366",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "REED",
    "FirstName": "AUDREY",
    "MiddleName": "MARIE",
    "NamePrefix": "MS.",
    "NameSuffix": null,
    "Credential": "MOBILE PHLEBOTOMIST",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "REED",
    "OtherFirstName": "AUDREY",
    "OtherMiddleName": "MARIE",
    "OtherNamePrefix": "MS.",
    "OtherNameSuffix": null,
    "OtherCredential": "PHLEBOTOMIST",
    "OtherLastNameTypeCode": "2",
    "FirstLineMailingAddress": "3222 WINCHESTER HWY",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "HILLSBORO",
    "MailingAddressStateName": "TN",
    "MailingAddressPostalCode": "37342-3737",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "931-315-9736",
    "MailingAddressFaxNumber": "931-233-9961",
    "FirstLinePracticeLocationAddress": "3222 WINCHESTER HWY",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "HILLSBORO",
    "PracticeLocationAddressStateName": "TN",
    "PracticeLocationAddressPostalCode": "37342-3737",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "931-315-9736",
    "PracticeLocationAddressFaxNumber": "931-233-9961",
    "EnumerationDate": "03/09/2021",
    "LastUpdateDate": "03/09/2021",
    "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": "202K00000X",
        "TaxonomyName": "Phlebology Physician",
        "LicenseNumber": "1103540",
        "LicenseNumberStateCode": "TN",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
      }
    }
  }
}
                
            

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