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1114844255 NPI number — BRANDY L BENNER BSW

NPI Number: 1114844255
Health Care Provider/Practitioner: BRANDY L BENNER BSW

Information about “1114844255” NPI (BRANDY L BENNER BSW) exists in 1114844255 in HTML format HTML  |  1114844255 in plain Text format TXT  |  1114844255 in PDF (Portable Document Format) PDF  |  1114844255 in an XML format XML  formats.

NPI Number : 1114844255 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1114844255",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BENNER",
    "FirstName": "BRANDY",
    "MiddleName": "L",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "BSW",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "419 22ND AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "LEWISTON",
    "MailingAddressStateName": "ID",
    "MailingAddressPostalCode": "83501-3812",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "208-746-3388",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "419 22ND AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LEWISTON",
    "PracticeLocationAddressStateName": "ID",
    "PracticeLocationAddressPostalCode": "83501-3812",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "208-746-3388",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "06/30/2026",
    "LastUpdateDate": "06/30/2026",
    "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": "171M00000X",
        "TaxonomyName": "Case Manager/Care Coordinator",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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