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1407495062 NPI number — KIZZY MICHELLE MCCRAY-SHEPPARD

NPI Number: 1407495062
Health Care Provider/Practitioner: KIZZY MICHELLE MCCRAY-SHEPPARD

Information about “1407495062” NPI (KIZZY MICHELLE MCCRAY-SHEPPARD) exists in 1407495062 in HTML format HTML  |  1407495062 in plain Text format TXT  |  1407495062 in PDF (Portable Document Format) PDF  |  1407495062 in an XML format XML  formats.

NPI Number : 1407495062 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1407495062",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MCCRAY-SHEPPARD",
    "FirstName": "KIZZY",
    "MiddleName": "MICHELLE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1588 NE 47TH PL",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "GAINESVILLE",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "32609-8957",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "352-246-4836",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "4266 SUNBEAM RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "JACKSONVILLE",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "32257-2425",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "904-268-5200",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "12/31/2019",
    "LastUpdateDate": "12/31/2019",
    "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": "APRN11004298",
        "LicenseNumberStateCode": "FL",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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