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1336570506 NPI number — MARINA JUDITH-ROWE MCINTYRE FNP

NPI Number: 1336570506
Health Care Provider/Practitioner: MARINA JUDITH-ROWE MCINTYRE FNP

Information about “1336570506” NPI (MARINA JUDITH-ROWE MCINTYRE FNP) exists in 1336570506 in HTML format HTML  |  1336570506 in plain Text format TXT  |  1336570506 in PDF (Portable Document Format) PDF  |  1336570506 in an XML format XML  formats.

NPI Number : 1336570506 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1336570506",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MCINTYRE",
    "FirstName": "MARINA",
    "MiddleName": "JUDITH-ROWE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "FNP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "PO BOX 8093",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "KETCHIKAN",
    "MailingAddressStateName": "AK",
    "MailingAddressPostalCode": "99901-3093",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "907-247-6724",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "3528 TONGASS AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "KETCHIKAN",
    "PracticeLocationAddressStateName": "AK",
    "PracticeLocationAddressPostalCode": "99901-5635",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "907-617-4481",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "12/12/2013",
    "LastUpdateDate": "03/04/2021",
    "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": "163WE0003X",
          "TaxonomyName": "Emergency Registered Nurse",
          "LicenseNumber": "23560",
          "LicenseNumberStateCode": "AK",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LF0000X",
          "TaxonomyName": "Family Nurse Practitioner",
          "LicenseNumber": "1445",
          "LicenseNumberStateCode": "AK",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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