NPI Code Detail JSON Logo

1134765886 NPI number — EVA MARIE BLACK FNP-BC

NPI Number: 1134765886
Health Care Provider/Practitioner: EVA MARIE BLACK FNP-BC

Information about “1134765886” NPI (EVA MARIE BLACK FNP-BC) exists in 1134765886 in HTML format HTML  |  1134765886 in plain Text format TXT  |  1134765886 in PDF (Portable Document Format) PDF  |  1134765886 in an XML format XML  formats.

NPI Number : 1134765886 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1134765886",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BLACK",
    "FirstName": "EVA",
    "MiddleName": "MARIE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "FNP-BC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "91 PHOENIX AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CARROLLTON",
    "MailingAddressStateName": "AL",
    "MailingAddressPostalCode": "35447-2351",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "662-549-4050",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "376 COMMERCE AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "CARROLLTON",
    "PracticeLocationAddressStateName": "AL",
    "PracticeLocationAddressPostalCode": "35447-2253",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "205-614-6228",
    "PracticeLocationAddressFaxNumber": "205-367-1612",
    "EnumerationDate": "11/18/2019",
    "LastUpdateDate": "07/31/2025",
    "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": "901756",
          "LicenseNumberStateCode": "MS",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LF0000X",
          "TaxonomyName": "Family Nurse Practitioner",
          "LicenseNumber": "1-168015",
          "LicenseNumberStateCode": "AL",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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