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1326351339 NPI number — HEATHER RENEE BLACK R.N.

NPI Number: 1326351339
Health Care Provider/Practitioner: HEATHER RENEE BLACK R.N.

Information about “1326351339” NPI (HEATHER RENEE BLACK R.N.) exists in 1326351339 in HTML format HTML  |  1326351339 in plain Text format TXT  |  1326351339 in PDF (Portable Document Format) PDF  |  1326351339 in an XML format XML  formats.

NPI Number : 1326351339 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1326351339",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BLACK",
    "FirstName": "HEATHER",
    "MiddleName": "RENEE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "R.N.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "DIXON",
    "OtherFirstName": "HEATHER",
    "OtherMiddleName": "RENEE",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "232 2ND AVE SE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CUT BANK",
    "MailingAddressStateName": "MT",
    "MailingAddressPostalCode": "59427-3416",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "406-845-4993",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "760 HOSPITAL CIRCLE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "BROWNING",
    "PracticeLocationAddressStateName": "MT",
    "PracticeLocationAddressPostalCode": "59417",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "406-338-6100",
    "PracticeLocationAddressFaxNumber": "406-338-6195",
    "EnumerationDate": "07/19/2010",
    "LastUpdateDate": "06/05/2021",
    "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": "163WC0400X",
          "TaxonomyName": "Case Management Registered Nurse",
          "LicenseNumber": "126733",
          "LicenseNumberStateCode": "MT",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "163WG0000X",
          "TaxonomyName": "General Practice Registered Nurse",
          "LicenseNumber": "126733",
          "LicenseNumberStateCode": "MT",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "163WM0705X",
          "TaxonomyName": "Medical-Surgical Registered Nurse",
          "LicenseNumber": "126733",
          "LicenseNumberStateCode": "MT",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "163WP2201X",
          "TaxonomyName": "Ambulatory Care Registered Nurse",
          "LicenseNumber": "126733",
          "LicenseNumberStateCode": "MT",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "163WP2201X",
          "TaxonomyName": "Ambulatory Care Registered Nurse",
          "LicenseNumber": "31609",
          "LicenseNumberStateCode": "AK",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY  GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
      }
    }
  }
}
                
            

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