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1295452951 NPI number — CAROLYN GURGANUS PATTERSON RBT

NPI Number: 1295452951
Health Care Provider/Practitioner: CAROLYN GURGANUS PATTERSON RBT

Information about “1295452951” NPI (CAROLYN GURGANUS PATTERSON RBT) exists in 1295452951 in HTML format HTML  |  1295452951 in plain Text format TXT  |  1295452951 in PDF (Portable Document Format) PDF  |  1295452951 in an XML format XML  formats.

NPI Number : 1295452951 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1295452951",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "PATTERSON",
    "FirstName": "CAROLYN",
    "MiddleName": "GURGANUS",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "RBT",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "GURGANUS",
    "OtherFirstName": "CAROLYN",
    "OtherMiddleName": "BROOKE",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "500 SPINNAKER ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "ELIZABETH CITY",
    "MailingAddressStateName": "NC",
    "MailingAddressPostalCode": "27909-6681",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "252-331-9333",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "373 EDWIN DR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "VIRGINIA BEACH",
    "PracticeLocationAddressStateName": "VA",
    "PracticeLocationAddressPostalCode": "23462-4522",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "757-301-2411",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "10/24/2022",
    "LastUpdateDate": "02/05/2025",
    "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": "106S00000X",
        "TaxonomyName": "Behavior Technician",
        "LicenseNumber": "RBT-22-240963",
        "LicenseNumberStateCode": "NC",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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