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1407512403 NPI number — KRISTEN BAGBY

NPI Number: 1407512403
Health Care Provider/Practitioner: KRISTEN BAGBY

Information about “1407512403” NPI (KRISTEN BAGBY) exists in 1407512403 in HTML format HTML  |  1407512403 in plain Text format TXT  |  1407512403 in PDF (Portable Document Format) PDF  |  1407512403 in an XML format XML  formats.

NPI Number : 1407512403 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1407512403",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BAGBY",
    "FirstName": "KRISTEN",
    "MiddleName": null,
    "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": "209 LLOYD ST STE 260",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CARRBORO",
    "MailingAddressStateName": "NC",
    "MailingAddressPostalCode": "27510-1856",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "919-240-4561",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "209 LLOYD ST STE 260",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "CARRBORO",
    "PracticeLocationAddressStateName": "NC",
    "PracticeLocationAddressPostalCode": "27510-1856",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "919-240-4561",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "11/14/2021",
    "LastUpdateDate": "08/29/2023",
    "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": "274815",
          "LicenseNumberStateCode": "NC",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LP0808X",
          "TaxonomyName": "Psychiatric/Mental Health Nurse Practitioner",
          "LicenseNumber": "5015639",
          "LicenseNumberStateCode": "NC",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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