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1376837989 NPI number — KATERINA MOORE N.P.-C

NPI Number: 1376837989
Health Care Provider/Practitioner: KATERINA MOORE N.P.-C

Information about “1376837989” NPI (KATERINA MOORE N.P.-C) exists in 1376837989 in HTML format HTML  |  1376837989 in plain Text format TXT  |  1376837989 in PDF (Portable Document Format) PDF  |  1376837989 in an XML format XML  formats.

NPI Number : 1376837989 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1376837989",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MOORE",
    "FirstName": "KATERINA",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "N.P.-C",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "11001 N BLACK CANYON HWY",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "PHOENIX",
    "MailingAddressStateName": "AZ",
    "MailingAddressPostalCode": "85029-4757",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "602-942-4462",
    "MailingAddressFaxNumber": "602-371-2002",
    "FirstLinePracticeLocationAddress": "3535 W SOUTHERN AVE",
    "SecondLinePracticeLocationAddress": "SUITE 128",
    "PracticeLocationAddressCityName": "PHOENIX",
    "PracticeLocationAddressStateName": "AZ",
    "PracticeLocationAddressPostalCode": "85041-4224",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "602-276-5563",
    "PracticeLocationAddressFaxNumber": "602-276-5536",
    "EnumerationDate": "06/01/2011",
    "LastUpdateDate": "06/03/2011",
    "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": "163W00000X",
          "TaxonomyName": "Registered Nurse",
          "LicenseNumber": "RN118161",
          "LicenseNumberStateCode": "AZ",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LF0000X",
          "TaxonomyName": "Family Nurse Practitioner",
          "LicenseNumber": "AP4070",
          "LicenseNumberStateCode": "AZ",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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