NPI Code Detail JSON Logo

1225967615 NPI number — BRENNA FAHY PRUNTY

NPI Number: 1225967615
Health Care Provider/Practitioner: BRENNA FAHY PRUNTY

Information about “1225967615” NPI (BRENNA FAHY PRUNTY) exists in 1225967615 in HTML format HTML  |  1225967615 in plain Text format TXT  |  1225967615 in PDF (Portable Document Format) PDF  |  1225967615 in an XML format XML  formats.

NPI Number : 1225967615 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1225967615",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "PRUNTY",
    "FirstName": "BRENNA",
    "MiddleName": "FAHY",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "224 PEPPERTREE LN APT 77",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "WINCHESTER",
    "MailingAddressStateName": "VA",
    "MailingAddressPostalCode": "22601-3586",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "44081 PIPELINE PLZ STE 120",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "ASHBURN",
    "PracticeLocationAddressStateName": "VA",
    "PracticeLocationAddressPostalCode": "20147-5892",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "703-723-7270",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "05/14/2026",
    "LastUpdateDate": "05/14/2026",
    "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": "235Z00000X",
        "TaxonomyName": "Speech-Language Pathologist",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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