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1407988967 NPI number — CYNTHIA VERMILLION DECKERT NURSE

NPI Number: 1407988967
Health Care Provider/Practitioner: CYNTHIA VERMILLION DECKERT NURSE

Information about “1407988967” NPI (CYNTHIA VERMILLION DECKERT NURSE) exists in 1407988967 in HTML format HTML  |  1407988967 in plain Text format TXT  |  1407988967 in PDF (Portable Document Format) PDF  |  1407988967 in an XML format XML  formats.

NPI Number : 1407988967 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1407988967",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "DECKERT",
    "FirstName": "CYNTHIA",
    "MiddleName": "VERMILLION",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "NURSE",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "VERMILLION",
    "OtherFirstName": "CYNTHIA",
    "OtherMiddleName": "ANNITA",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "NURSE",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "PO BOX 367",
    "SecondLineMailingAddress": "82936 OAK DR",
    "MailingAddressCityName": "DEXTER",
    "MailingAddressStateName": "OR",
    "MailingAddressPostalCode": "97431-0367",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "503-539-4363",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "3225 STATE ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SALEM",
    "PracticeLocationAddressStateName": "OR",
    "PracticeLocationAddressPostalCode": "97301-5063",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "503-584-2301",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "03/11/2007",
    "LastUpdateDate": "07/08/2007",
    "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": null,
        "LicenseNumberStateCode": "OR",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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