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1154083228 NPI number — STEVI WILLIAMS TOBERMAN AGAC-NP

NPI Number: 1154083228
Health Care Provider/Practitioner: STEVI WILLIAMS TOBERMAN AGAC-NP

Information about “1154083228” NPI (STEVI WILLIAMS TOBERMAN AGAC-NP) exists in 1154083228 in HTML format HTML  |  1154083228 in plain Text format TXT  |  1154083228 in PDF (Portable Document Format) PDF  |  1154083228 in an XML format XML  formats.

NPI Number : 1154083228 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1154083228",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "TOBERMAN",
    "FirstName": "STEVI",
    "MiddleName": "WILLIAMS",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "AGAC-NP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "WILLIAMS",
    "OtherFirstName": "STEVI",
    "OtherMiddleName": "HILL",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "AGAC-NP",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "1121 NORTH CHURCH ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "GREENSBORO",
    "MailingAddressStateName": "NC",
    "MailingAddressPostalCode": "27401",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1200 N ELM ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "GREENSBORO",
    "PracticeLocationAddressStateName": "NC",
    "PracticeLocationAddressPostalCode": "27401-1004",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "336-832-2820",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "10/06/2021",
    "LastUpdateDate": "11/18/2021",
    "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": "363LA2100X",
          "TaxonomyName": "Acute Care Nurse Practitioner",
          "LicenseNumber": "5015128",
          "LicenseNumberStateCode": "NC",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LA2200X",
          "TaxonomyName": "Adult Health Nurse Practitioner",
          "LicenseNumber": "5015128",
          "LicenseNumberStateCode": "NC",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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