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1265099303 NPI number — SARAH EMILY BUCKNER RN, AGNP-C

NPI Number: 1265099303
Health Care Provider/Practitioner: SARAH EMILY BUCKNER RN, AGNP-C

Information about “1265099303” NPI (SARAH EMILY BUCKNER RN, AGNP-C) exists in 1265099303 in HTML format HTML  |  1265099303 in plain Text format TXT  |  1265099303 in PDF (Portable Document Format) PDF  |  1265099303 in an XML format XML  formats.

NPI Number : 1265099303 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1265099303",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BUCKNER",
    "FirstName": "SARAH",
    "MiddleName": "EMILY",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "RN, AGNP-C",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "DICKEY",
    "OtherFirstName": "SARAH",
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "1120 MAYWOOD DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "EUREKA",
    "MailingAddressStateName": "MO",
    "MailingAddressPostalCode": "63025-2766",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "636-236-6958",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1400 US HIGHWAY 61 STE G50",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "FESTUS",
    "PracticeLocationAddressStateName": "MO",
    "PracticeLocationAddressPostalCode": "63028-4142",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "314-366-4874",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "05/23/2019",
    "LastUpdateDate": "05/23/2019",
    "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": "163W00000X",
          "TaxonomyName": "Registered Nurse",
          "LicenseNumber": "2009023414",
          "LicenseNumberStateCode": "MO",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LA2200X",
          "TaxonomyName": "Adult Health Nurse Practitioner",
          "LicenseNumber": "AP140436",
          "LicenseNumberStateCode": "TX",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LA2200X",
          "TaxonomyName": "Adult Health Nurse Practitioner",
          "LicenseNumber": "2018034003",
          "LicenseNumberStateCode": "MO",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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