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1215479506 NPI number — KERRY JO PHAM ARNP, CNM

NPI Number: 1215479506
Health Care Provider/Practitioner: KERRY JO PHAM ARNP, CNM

Information about “1215479506” NPI (KERRY JO PHAM ARNP, CNM) exists in 1215479506 in HTML format HTML  |  1215479506 in plain Text format TXT  |  1215479506 in PDF (Portable Document Format) PDF  |  1215479506 in an XML format XML  formats.

NPI Number : 1215479506 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1215479506",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "PHAM",
    "FirstName": "KERRY",
    "MiddleName": "JO",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "ARNP, CNM",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "975 ROYCE ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "PENSACOLA",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "32503-2463",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "850-361-7250",
    "MailingAddressFaxNumber": "850-610-4277",
    "FirstLinePracticeLocationAddress": "975 ROYCE ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "PENSACOLA",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "32503-2463",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "850-361-7250",
    "PracticeLocationAddressFaxNumber": "850-610-4277",
    "EnumerationDate": "11/17/2016",
    "LastUpdateDate": "02/04/2024",
    "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": "367A00000X",
        "TaxonomyName": "Advanced Practice Midwife",
        "LicenseNumber": "ARNP9265686",
        "LicenseNumberStateCode": "FL",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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