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1295395374 NPI number — RACHELLE DUPONT ST. ANGELO FNP

NPI Number: 1295395374
Health Care Provider/Practitioner: RACHELLE DUPONT ST. ANGELO FNP

Information about “1295395374” NPI (RACHELLE DUPONT ST. ANGELO FNP) exists in 1295395374 in HTML format HTML  |  1295395374 in plain Text format TXT  |  1295395374 in PDF (Portable Document Format) PDF  |  1295395374 in an XML format XML  formats.

NPI Number : 1295395374 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1295395374",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "ST. ANGELO",
    "FirstName": "RACHELLE",
    "MiddleName": "DUPONT",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "FNP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "3056 ORLEANS QUARTERS DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BRUSLY",
    "MailingAddressStateName": "LA",
    "MailingAddressPostalCode": "70719-2199",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "225-776-6175",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "25455 HIGHWAY 1",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "PLAQUEMINE",
    "PracticeLocationAddressStateName": "LA",
    "PracticeLocationAddressPostalCode": "70764-7513",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "225-754-6880",
    "PracticeLocationAddressFaxNumber": "225-754-6885",
    "EnumerationDate": "06/19/2019",
    "LastUpdateDate": "06/19/2019",
    "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": "363LF0000X",
        "TaxonomyName": "Family Nurse Practitioner",
        "LicenseNumber": "206497",
        "LicenseNumberStateCode": "LA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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