1245488162 NPI number — BRANDI L MARCUM AU.D., CCC-A

NPI Number: 1245488162
Health Care Provider/Practitioner: BRANDI L MARCUM AU.D., CCC-A

NPI Number : 1245488162 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1245488162",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MARCUM",
    "FirstName": "BRANDI",
    "MiddleName": "L",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "AU.D., CCC-A",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "KING",
    "OtherFirstName": "BRANDI",
    "OtherMiddleName": "L",
    "OtherNamePrefix": "MISS",
    "OtherNameSuffix": null,
    "OtherCredential": "AU.D., CCC-A",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "1609 ROSEWOOD DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "COLUMBIA",
    "MailingAddressStateName": "TN",
    "MailingAddressPostalCode": "38401-6420",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "931-381-0831",
    "MailingAddressFaxNumber": "931-380-0750",
    "FirstLinePracticeLocationAddress": "1609 ROSEWOOD DR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "COLUMBIA",
    "PracticeLocationAddressStateName": "TN",
    "PracticeLocationAddressPostalCode": "38401-6420",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "931-381-0831",
    "PracticeLocationAddressFaxNumber": "931-380-0750",
    "EnumerationDate": "09/04/2008",
    "LastUpdateDate": "03/19/2009",
    "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": "231H00000X",
        "TaxonomyName": "Audiologist",
        "LicenseNumber": "A1511",
        "LicenseNumberStateCode": "TN",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}