NPI Code Detail JSON Logo

1245279900 NPI number — CONNIE J CLARY ANP/GNP

NPI Number: 1245279900
Health Care Provider/Practitioner: CONNIE J CLARY ANP/GNP

Information about “1245279900” NPI (CONNIE J CLARY ANP/GNP) exists in 1245279900 in HTML format HTML  |  1245279900 in plain Text format TXT  |  1245279900 in PDF (Portable Document Format) PDF  |  1245279900 in an XML format XML  formats.

NPI Number : 1245279900 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1245279900",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "CLARY",
    "FirstName": "CONNIE",
    "MiddleName": "J",
    "NamePrefix": "MS.",
    "NameSuffix": null,
    "Credential": "ANP/GNP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "WILSON",
    "OtherFirstName": "CONNIE",
    "OtherMiddleName": "J",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "PO BOX 31235",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "TUCSON",
    "MailingAddressStateName": "AZ",
    "MailingAddressPostalCode": "85751-1235",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "520-324-4780",
    "MailingAddressFaxNumber": "520-324-1406",
    "FirstLinePracticeLocationAddress": "10350 E DREXEL RD UNIT 110",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "TUCSON",
    "PracticeLocationAddressStateName": "AZ",
    "PracticeLocationAddressPostalCode": "85747-9409",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "520-324-1727",
    "PracticeLocationAddressFaxNumber": "520-324-1700",
    "EnumerationDate": "06/06/2006",
    "LastUpdateDate": "05/13/2021",
    "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": "363LA2200X",
        "TaxonomyName": "Adult Health Nurse Practitioner",
        "LicenseNumber": "AP7025",
        "LicenseNumberStateCode": "AZ",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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