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1164072534 NPI number — MELISSA DAWN WHITE APRN-CNP

NPI Number: 1164072534
Health Care Provider/Practitioner: MELISSA DAWN WHITE APRN-CNP

Information about “1164072534” NPI (MELISSA DAWN WHITE APRN-CNP) exists in 1164072534 in HTML format HTML  |  1164072534 in plain Text format TXT  |  1164072534 in PDF (Portable Document Format) PDF  |  1164072534 in an XML format XML  formats.

NPI Number : 1164072534 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1164072534",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "WHITE",
    "FirstName": "MELISSA",
    "MiddleName": "DAWN",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "APRN-CNP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "MEYER",
    "OtherFirstName": "MELISSA",
    "OtherMiddleName": "DAWN",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "PO BOX 1239",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "HANNIBAL",
    "MailingAddressStateName": "MO",
    "MailingAddressPostalCode": "63401-1239",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "573-248-5403",
    "MailingAddressFaxNumber": "573-248-5419",
    "FirstLinePracticeLocationAddress": "211 S 3RD ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LOUISIANA",
    "PracticeLocationAddressStateName": "MO",
    "PracticeLocationAddressPostalCode": "63353-2000",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "573-754-5555",
    "PracticeLocationAddressFaxNumber": "573-754-5932",
    "EnumerationDate": "09/17/2019",
    "LastUpdateDate": "08/12/2024",
    "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": "363L00000X",
          "TaxonomyName": "Nurse Practitioner",
          "LicenseNumber": "R0119396",
          "LicenseNumberStateCode": "MO",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LA2200X",
          "TaxonomyName": "Adult Health Nurse Practitioner",
          "LicenseNumber": "119396",
          "LicenseNumberStateCode": "OK",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LG0600X",
          "TaxonomyName": "Gerontology Nurse Practitioner",
          "LicenseNumber": "2022025341",
          "LicenseNumberStateCode": "MO",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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