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1255571816 NPI number — MELANIE M PANCHAL ACNP-BC

NPI Number: 1255571816
Health Care Provider/Practitioner: MELANIE M PANCHAL ACNP-BC

Information about “1255571816” NPI (MELANIE M PANCHAL ACNP-BC) exists in 1255571816 in HTML format HTML  |  1255571816 in plain Text format TXT  |  1255571816 in PDF (Portable Document Format) PDF  |  1255571816 in an XML format XML  formats.

NPI Number : 1255571816 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1255571816",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "PANCHAL",
    "FirstName": "MELANIE",
    "MiddleName": "M",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "ACNP-BC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "MORGIA",
    "OtherFirstName": "MELANIE",
    "OtherMiddleName": "M",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "11017 BARTLETT AVE NE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SEATTLE",
    "MailingAddressStateName": "WA",
    "MailingAddressPostalCode": "98125-5828",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "630-854-6563",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1145 BROADWAY",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SEATTLE",
    "PracticeLocationAddressStateName": "WA",
    "PracticeLocationAddressPostalCode": "98122-4201",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "206-860-4500",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "02/23/2009",
    "LastUpdateDate": "06/23/2021",
    "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": "363LA2100X",
          "TaxonomyName": "Acute Care Nurse Practitioner",
          "LicenseNumber": "2009001031",
          "LicenseNumberStateCode": "IL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LA2100X",
          "TaxonomyName": "Acute Care Nurse Practitioner",
          "LicenseNumber": "AP60145026",
          "LicenseNumberStateCode": "WA",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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