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1356407720 NPI number — MARY M BRANT FPMHNP

NPI Number: 1356407720
Health Care Provider/Practitioner: MARY M BRANT FPMHNP

Information about “1356407720” NPI (MARY M BRANT FPMHNP) exists in 1356407720 in HTML format HTML  |  1356407720 in plain Text format TXT  |  1356407720 in PDF (Portable Document Format) PDF  |  1356407720 in an XML format XML  formats.

NPI Number : 1356407720 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1356407720",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BRANT",
    "FirstName": "MARY",
    "MiddleName": "M",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "FPMHNP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "ELDRED",
    "OtherFirstName": "MARY",
    "OtherMiddleName": "M",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "PO BOX 844715",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "KANSAS CITY",
    "MailingAddressStateName": "MO",
    "MailingAddressPostalCode": "64184-4715",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "417-761-5214",
    "MailingAddressFaxNumber": "417-761-5065",
    "FirstLinePracticeLocationAddress": "17844 E 23RD ST S",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "INDEPENDENCE",
    "PracticeLocationAddressStateName": "MO",
    "PracticeLocationAddressPostalCode": "64057-1840",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "816-254-3652",
    "PracticeLocationAddressFaxNumber": "816-254-9243",
    "EnumerationDate": "12/29/2006",
    "LastUpdateDate": "01/30/2026",
    "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": "103TC0700X",
          "TaxonomyName": "Clinical Psychologist",
          "LicenseNumber": "2007000444",
          "LicenseNumberStateCode": "MO",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LP0808X",
          "TaxonomyName": "Psychiatric/Mental Health Nurse Practitioner",
          "LicenseNumber": "2021028550",
          "LicenseNumberStateCode": "MO",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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