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1194795047 NPI number — MRS. JOANN L CARSON

NPI Number: 1194795047
Health Care Provider/Practitioner: MRS. JOANN L CARSON

Information about “1194795047” NPI (MRS. JOANN L CARSON) exists in 1194795047 in HTML format HTML  |  1194795047 in plain Text format TXT  |  1194795047 in PDF (Portable Document Format) PDF  |  1194795047 in an XML format XML  formats.

NPI Number : 1194795047 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1194795047",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "CARSON",
    "FirstName": "JOANN",
    "MiddleName": "L",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "9488 LAKEVIEW CT",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "DOUGLASVILLE",
    "MailingAddressStateName": "GA",
    "MailingAddressPostalCode": "30135",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "770-947-4210",
    "MailingAddressFaxNumber": "770-830-0990",
    "FirstLinePracticeLocationAddress": "160 CLINIC AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "CARROLLTON",
    "PracticeLocationAddressStateName": "GA",
    "PracticeLocationAddressPostalCode": "30117-4451",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "770-834-1008",
    "PracticeLocationAddressFaxNumber": "770-834-2531",
    "EnumerationDate": "01/24/2006",
    "LastUpdateDate": "05/11/2012",
    "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": "367500000X",
        "TaxonomyName": "Certified Registered Nurse Anesthetist",
        "LicenseNumber": "RN130954CRNA",
        "LicenseNumberStateCode": "GA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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