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1134870421 NPI number — VERONICA BURNETTE OWNER ADULT MEDICAL

NPI Number: 1134870421
Health Care Provider/Practitioner: VERONICA BURNETTE OWNER ADULT MEDICAL

Information about “1134870421” NPI (VERONICA BURNETTE OWNER ADULT MEDICAL) exists in 1134870421 in HTML format HTML  |  1134870421 in plain Text format TXT  |  1134870421 in PDF (Portable Document Format) PDF  |  1134870421 in an XML format XML  formats.

NPI Number : 1134870421 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1134870421",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BURNETTE",
    "FirstName": "VERONICA",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "OWNER ADULT MEDICAL",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "7806 ROLLING VISTA CT",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BALTIMORE",
    "MailingAddressStateName": "MD",
    "MailingAddressPostalCode": "21236-3643",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "443-983-9918",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1500 COUNTRY RIDGE LN",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "ESSEX",
    "PracticeLocationAddressStateName": "MD",
    "PracticeLocationAddressPostalCode": "21221-3906",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "410-871-0101",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "01/18/2022",
    "LastUpdateDate": "01/18/2022",
    "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": "103TM1800X",
        "TaxonomyName": "Intellectual & Developmental Disabilities Psychologist",
        "LicenseNumber": "R135126",
        "LicenseNumberStateCode": "MD",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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