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1366256463 NPI number — MAKENZIE ANNE HALL ACNP-AG

NPI Number: 1366256463
Health Care Provider/Practitioner: MAKENZIE ANNE HALL ACNP-AG

Information about “1366256463” NPI (MAKENZIE ANNE HALL ACNP-AG) exists in 1366256463 in HTML format HTML  |  1366256463 in plain Text format TXT  |  1366256463 in PDF (Portable Document Format) PDF  |  1366256463 in an XML format XML  formats.

NPI Number : 1366256463 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1366256463",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "HALL",
    "FirstName": "MAKENZIE",
    "MiddleName": "ANNE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "ACNP-AG",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "ROE",
    "OtherFirstName": "MAKENZIE",
    "OtherMiddleName": "ANNE",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "RN",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "522 S WALNUT ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BRAZIL",
    "MailingAddressStateName": "IN",
    "MailingAddressPostalCode": "47834-3151",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "812-691-3777",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1606 N 7TH ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "TERRE HAUTE",
    "PracticeLocationAddressStateName": "IN",
    "PracticeLocationAddressPostalCode": "47804-2706",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "812-691-3777",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "02/07/2025",
    "LastUpdateDate": "10/08/2025",
    "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": "363L00000X",
        "TaxonomyName": "Nurse Practitioner",
        "LicenseNumber": "71017021A",
        "LicenseNumberStateCode": "IN",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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