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1205883477 NPI number — JESSICA FAE WOY GOULD PA-C

NPI Number: 1205883477
Health Care Provider/Practitioner: JESSICA FAE WOY GOULD PA-C

Information about “1205883477” NPI (JESSICA FAE WOY GOULD PA-C) exists in 1205883477 in HTML format HTML  |  1205883477 in plain Text format TXT  |  1205883477 in PDF (Portable Document Format) PDF  |  1205883477 in an XML format XML  formats.

NPI Number : 1205883477 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1205883477",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "WOY GOULD",
    "FirstName": "JESSICA",
    "MiddleName": "FAE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "PA-C",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "WOY",
    "OtherFirstName": "JESSICA",
    "OtherMiddleName": "FAE",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "PA-C",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "PO BOX 944",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "KEYSER",
    "MailingAddressStateName": "WV",
    "MailingAddressPostalCode": "26726-0944",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "304-788-6462",
    "MailingAddressFaxNumber": "304-788-6555",
    "FirstLinePracticeLocationAddress": "RR 3 BOX 3267",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "KEYSER",
    "PracticeLocationAddressStateName": "WV",
    "PracticeLocationAddressPostalCode": "26726-9422",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "304-788-6462",
    "PracticeLocationAddressFaxNumber": "304-788-6555",
    "EnumerationDate": "05/31/2006",
    "LastUpdateDate": "08/21/2012",
    "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": "207Q00000X",
        "TaxonomyName": "Family Medicine Physician",
        "LicenseNumber": "01035",
        "LicenseNumberStateCode": "WV",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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