NPI Code Detail JSON Logo

1174828446 NPI number — ALEXANDRIA MARIE SARA NP

NPI Number: 1174828446
Health Care Provider/Practitioner: ALEXANDRIA MARIE SARA NP

Information about “1174828446” NPI (ALEXANDRIA MARIE SARA NP) exists in 1174828446 in HTML format HTML  |  1174828446 in plain Text format TXT  |  1174828446 in PDF (Portable Document Format) PDF  |  1174828446 in an XML format XML  formats.

NPI Number : 1174828446 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1174828446",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "SARA",
    "FirstName": "ALEXANDRIA",
    "MiddleName": "MARIE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "NP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "MCCLURE",
    "OtherFirstName": "ALEXANDRIA",
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "PO BOX 81064",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CLEVELAND",
    "MailingAddressStateName": "OH",
    "MailingAddressPostalCode": "44181-0064",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "520-795-8080",
    "MailingAddressFaxNumber": "520-323-6237",
    "FirstLinePracticeLocationAddress": "1005 DIVISION ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "PRESCOTT",
    "PracticeLocationAddressStateName": "AZ",
    "PracticeLocationAddressPostalCode": "86301-1601",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "928-776-8428",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "01/18/2011",
    "LastUpdateDate": "02/20/2025",
    "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": "363LW0102X",
          "TaxonomyName": "Women's Health Nurse Practitioner",
          "LicenseNumber": "SP028517",
          "LicenseNumberStateCode": "PA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363L00000X",
          "TaxonomyName": "Nurse Practitioner",
          "LicenseNumber": "15585",
          "LicenseNumberStateCode": "TN",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LA2200X",
          "TaxonomyName": "Adult Health Nurse Practitioner",
          "LicenseNumber": "15585",
          "LicenseNumberStateCode": "TN",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LW0102X",
          "TaxonomyName": "Women's Health Nurse Practitioner",
          "LicenseNumber": "4704348250",
          "LicenseNumberStateCode": "MI",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LW0102X",
          "TaxonomyName": "Women's Health Nurse Practitioner",
          "LicenseNumber": "15585",
          "LicenseNumberStateCode": "TN",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LW0102X",
          "TaxonomyName": "Women's Health Nurse Practitioner",
          "LicenseNumber": "313964",
          "LicenseNumberStateCode": "AZ",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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