NPI Code Detail JSON Logo

1215782636 NPI number — DR. GRACE NSIKAN OKON

NPI Number: 1215782636
Health Care Provider/Practitioner: DR. GRACE NSIKAN OKON

Information about “1215782636” NPI (DR. GRACE NSIKAN OKON) exists in 1215782636 in HTML format HTML  |  1215782636 in plain Text format TXT  |  1215782636 in PDF (Portable Document Format) PDF  |  1215782636 in an XML format XML  formats.

NPI Number : 1215782636 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1215782636",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "OKON",
    "FirstName": "GRACE",
    "MiddleName": "NSIKAN",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "343 WOLF CREEK DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "WAXAHACHIE",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "75165-1658",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "218-206-0938",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "WALGREENS PHARMACY",
    "SecondLinePracticeLocationAddress": "8110 HIGHWAY 100",
    "PracticeLocationAddressCityName": "BELLEVUE",
    "PracticeLocationAddressStateName": "TN",
    "PracticeLocationAddressPostalCode": "37221-4214",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "615-673-1251",
    "PracticeLocationAddressFaxNumber": "615-673-6489",
    "EnumerationDate": "04/19/2024",
    "LastUpdateDate": "04/19/2024",
    "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": "183500000X",
          "TaxonomyName": "Pharmacist",
          "LicenseNumber": "70033",
          "LicenseNumberStateCode": "TX",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "183500000X",
          "TaxonomyName": "Pharmacist",
          "LicenseNumber": "42711",
          "LicenseNumberStateCode": "TN",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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