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1265623763 NPI number — COURTNEY ELIZABETH HENNELLY APN

NPI Number: 1265623763
Health Care Provider/Practitioner: COURTNEY ELIZABETH HENNELLY APN

Information about “1265623763” NPI (COURTNEY ELIZABETH HENNELLY APN) exists in 1265623763 in HTML format HTML  |  1265623763 in plain Text format TXT  |  1265623763 in PDF (Portable Document Format) PDF  |  1265623763 in an XML format XML  formats.

NPI Number : 1265623763 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1265623763",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "HENNELLY",
    "FirstName": "COURTNEY",
    "MiddleName": "ELIZABETH",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "APN",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "136 MOUNTAINVIEW BLVD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BASKING RIDGE",
    "MailingAddressStateName": "NJ",
    "MailingAddressPostalCode": "07920-3444",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "908-542-3500",
    "MailingAddressFaxNumber": "908-542-3211",
    "FirstLinePracticeLocationAddress": "136 MOUNTAINVIEW BLVD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "BASKING RIDGE",
    "PracticeLocationAddressStateName": "NJ",
    "PracticeLocationAddressPostalCode": "07920-3444",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "908-542-3500",
    "PracticeLocationAddressFaxNumber": "908-542-3211",
    "EnumerationDate": "08/08/2007",
    "LastUpdateDate": "03/21/2012",
    "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": "363LF0000X",
          "TaxonomyName": "Family Nurse Practitioner",
          "LicenseNumber": "26NJ00345800",
          "LicenseNumberStateCode": "NJ",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LF0000X",
          "TaxonomyName": "Family Nurse Practitioner",
          "LicenseNumber": "33 334424",
          "LicenseNumberStateCode": "NY",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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