NPI Code Detail JSON Logo

1407674245 NPI number — MISTY ANN PREWITT

NPI Number: 1407674245
Health Care Provider/Practitioner: MISTY ANN PREWITT

Information about “1407674245” NPI (MISTY ANN PREWITT) exists in 1407674245 in HTML format HTML  |  1407674245 in plain Text format TXT  |  1407674245 in PDF (Portable Document Format) PDF  |  1407674245 in an XML format XML  formats.

NPI Number : 1407674245 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1407674245",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "PREWITT",
    "FirstName": "MISTY",
    "MiddleName": "ANN",
    "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": "4142 S 7TH ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "TERRE HAUTE",
    "MailingAddressStateName": "IN",
    "MailingAddressPostalCode": "47802-4123",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "423-239-5361",
    "MailingAddressFaxNumber": "800-524-8107",
    "FirstLinePracticeLocationAddress": "516 W OAKLAND AVE STE 106",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "JOHNSON CITY",
    "PracticeLocationAddressStateName": "TN",
    "PracticeLocationAddressPostalCode": "37604-1677",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "423-328-1244",
    "PracticeLocationAddressFaxNumber": "423-282-8397",
    "EnumerationDate": "10/01/2024",
    "LastUpdateDate": "10/01/2024",
    "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": "237700000X",
        "TaxonomyName": "Hearing Instrument Specialist",
        "LicenseNumber": "1066",
        "LicenseNumberStateCode": "TN",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.