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1285203448 NPI number — ELIZABETH A HANCOCK PTA

NPI Number: 1285203448
Health Care Provider/Practitioner: ELIZABETH A HANCOCK PTA

Information about “1285203448” NPI (ELIZABETH A HANCOCK PTA) exists in 1285203448 in HTML format HTML  |  1285203448 in plain Text format TXT  |  1285203448 in PDF (Portable Document Format) PDF  |  1285203448 in an XML format XML  formats.

NPI Number : 1285203448 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1285203448",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "HANCOCK",
    "FirstName": "ELIZABETH",
    "MiddleName": "A",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "PTA",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "HANCOCK",
    "OtherFirstName": "ANNIE",
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "PTA",
    "OtherLastNameTypeCode": "5",
    "FirstLineMailingAddress": "7402 W 34TH PL",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "TULSA",
    "MailingAddressStateName": "OK",
    "MailingAddressPostalCode": "74107-4508",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "918-695-7850",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "11414 E 51ST ST STE E",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "TULSA",
    "PracticeLocationAddressStateName": "OK",
    "PracticeLocationAddressPostalCode": "74146-5823",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "918-249-0623",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "06/22/2021",
    "LastUpdateDate": "06/22/2021",
    "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": "225200000X",
        "TaxonomyName": "Physical Therapy Assistant",
        "LicenseNumber": "283",
        "LicenseNumberStateCode": "OK",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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