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1396715264 NPI number — CHANDRA M. CRAVENS FNP

NPI Number: 1396715264
Health Care Provider/Practitioner: CHANDRA M. CRAVENS FNP

Information about “1396715264” NPI (CHANDRA M. CRAVENS FNP) exists in 1396715264 in HTML format HTML  |  1396715264 in plain Text format TXT  |  1396715264 in PDF (Portable Document Format) PDF  |  1396715264 in an XML format XML  formats.

NPI Number : 1396715264 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1396715264",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "CRAVENS",
    "FirstName": "CHANDRA",
    "MiddleName": "M.",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "FNP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "MCCARTY",
    "OtherFirstName": "CHANDRA",
    "OtherMiddleName": "BREN",
    "OtherNamePrefix": "MISS",
    "OtherNameSuffix": null,
    "OtherCredential": "FNP",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "PO BOX 1345",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "LAMPASAS",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "76550-0011",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "281-989-3319",
    "MailingAddressFaxNumber": "888-616-0348",
    "FirstLinePracticeLocationAddress": "111 W CENTRAL AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "TEMPLE",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "76501-7628",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "512-639-1323",
    "PracticeLocationAddressFaxNumber": "888-616-0348",
    "EnumerationDate": "01/24/2006",
    "LastUpdateDate": "10/03/2022",
    "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": "363LF0000X",
          "TaxonomyName": "Family Nurse Practitioner",
          "LicenseNumber": "658334",
          "LicenseNumberStateCode": "TX",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LF0000X",
          "TaxonomyName": "Family Nurse Practitioner",
          "LicenseNumber": "589146",
          "LicenseNumberStateCode": "CA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363L00000X",
          "TaxonomyName": "Nurse Practitioner",
          "LicenseNumber": "658334",
          "LicenseNumberStateCode": "TX",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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