NPI Code Detail JSON Logo

1225973803 NPI number — KANISHA MIKELL PMHNP-BC

NPI Number: 1225973803
Health Care Provider/Practitioner: KANISHA MIKELL PMHNP-BC

Information about “1225973803” NPI (KANISHA MIKELL PMHNP-BC) exists in 1225973803 in HTML format HTML  |  1225973803 in plain Text format TXT  |  1225973803 in PDF (Portable Document Format) PDF  |  1225973803 in an XML format XML  formats.

NPI Number : 1225973803 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1225973803",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MIKELL",
    "FirstName": "KANISHA",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "PMHNP-BC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "11429 CAMDEN COURT CIR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "GULFPORT",
    "MailingAddressStateName": "MS",
    "MailingAddressPostalCode": "39503-5758",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "228-265-0539",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1720A MEDICAL PARK DR STE 340-A",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "BILOXI",
    "PracticeLocationAddressStateName": "MS",
    "PracticeLocationAddressPostalCode": "39532-2129",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "228-265-0539",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "04/21/2026",
    "LastUpdateDate": "04/21/2026",
    "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": "363LP0808X",
        "TaxonomyName": "Psychiatric/Mental Health Nurse Practitioner",
        "LicenseNumber": "908279",
        "LicenseNumberStateCode": "MS",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.