NPI Code Detail JSON Logo

1174330518 NPI number — TRACEY AMBER DAWSON APRN

NPI Number: 1174330518
Health Care Provider/Practitioner: TRACEY AMBER DAWSON APRN

Information about “1174330518” NPI (TRACEY AMBER DAWSON APRN) exists in 1174330518 in HTML format HTML  |  1174330518 in plain Text format TXT  |  1174330518 in PDF (Portable Document Format) PDF  |  1174330518 in an XML format XML  formats.

NPI Number : 1174330518 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1174330518",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "DAWSON",
    "FirstName": "TRACEY",
    "MiddleName": "AMBER",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "APRN",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "FINN",
    "OtherFirstName": "TRACEY",
    "OtherMiddleName": "AMBER",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "243 ISLEVIEW DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "OSWEGO",
    "MailingAddressStateName": "IL",
    "MailingAddressPostalCode": "60543-9207",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "773-655-0442",
    "MailingAddressFaxNumber": "773-655-0442",
    "FirstLinePracticeLocationAddress": "9551 171ST ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "TINLEY PARK",
    "PracticeLocationAddressStateName": "IL",
    "PracticeLocationAddressPostalCode": "60487-6109",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "401-770-8391",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "12/17/2024",
    "LastUpdateDate": "12/17/2024",
    "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": "363LF0000X",
        "TaxonomyName": "Family Nurse Practitioner",
        "LicenseNumber": "209031258",
        "LicenseNumberStateCode": "IL",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.