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1144608019 NPI number — BERNARDINE EVANS PT,DPT,GCS

NPI Number: 1144608019
Health Care Provider/Practitioner: BERNARDINE EVANS PT,DPT,GCS

Information about “1144608019” NPI (BERNARDINE EVANS PT,DPT,GCS) exists in 1144608019 in HTML format HTML  |  1144608019 in plain Text format TXT  |  1144608019 in PDF (Portable Document Format) PDF  |  1144608019 in an XML format XML  formats.

NPI Number : 1144608019 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1144608019",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "EVANS",
    "FirstName": "BERNARDINE",
    "MiddleName": null,
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "PT,DPT,GCS",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "SPAULDING",
    "OtherFirstName": "BERNARDINE",
    "OtherMiddleName": null,
    "OtherNamePrefix": "MISS",
    "OtherNameSuffix": null,
    "OtherCredential": "PT",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "1701 POPLAR LN NW",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "WASHINGTON",
    "MailingAddressStateName": "DC",
    "MailingAddressPostalCode": "20012-1135",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "202-525-5572",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "2250 HICKORY RD STE 240",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "PLYMOUTH MEETING",
    "PracticeLocationAddressStateName": "PA",
    "PracticeLocationAddressPostalCode": "19462-2225",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "610-834-1122",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "05/12/2015",
    "LastUpdateDate": "05/12/2015",
    "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": "2251G0304X",
        "TaxonomyName": "Geriatric Physical Therapist",
        "LicenseNumber": "PT871083",
        "LicenseNumberStateCode": "DC",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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