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1316856537 NPI number — KEREEN SEMONE WALLER SIMPSON

NPI Number: 1316856537
Health Care Provider/Practitioner: KEREEN SEMONE WALLER SIMPSON

Information about “1316856537” NPI (KEREEN SEMONE WALLER SIMPSON) exists in 1316856537 in HTML format HTML  |  1316856537 in plain Text format TXT  |  1316856537 in PDF (Portable Document Format) PDF  |  1316856537 in an XML format XML  formats.

NPI Number : 1316856537 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1316856537",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "WALLER SIMPSON",
    "FirstName": "KEREEN",
    "MiddleName": "SEMONE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "PO BOX 185023",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "HAMDEN",
    "MailingAddressStateName": "CT",
    "MailingAddressPostalCode": "06518-0023",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "475-221-6620",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1106 NORTH AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "BRIDGEPORT",
    "PracticeLocationAddressStateName": "CT",
    "PracticeLocationAddressPostalCode": "06604-2710",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "475-225-8071",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "09/03/2026",
    "LastUpdateDate": "09/03/2026",
    "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": "363LG0600X",
        "TaxonomyName": "Gerontology Nurse Practitioner",
        "LicenseNumber": "144326",
        "LicenseNumberStateCode": "CT",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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