NPI Code Detail JSON Logo

1417746652 NPI number — ELIZABETH ANNE REYNOLDS RN

NPI Number: 1417746652
Health Care Provider/Practitioner: ELIZABETH ANNE REYNOLDS RN

Information about “1417746652” NPI (ELIZABETH ANNE REYNOLDS RN) exists in 1417746652 in HTML format HTML  |  1417746652 in plain Text format TXT  |  1417746652 in PDF (Portable Document Format) PDF  |  1417746652 in an XML format XML  formats.

NPI Number : 1417746652 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1417746652",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "REYNOLDS",
    "FirstName": "ELIZABETH",
    "MiddleName": "ANNE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "RN",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "CLARK",
    "OtherFirstName": "ELIZABETH",
    "OtherMiddleName": "ANNE",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "RN",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "318 W 800 S",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SALEM",
    "MailingAddressStateName": "UT",
    "MailingAddressPostalCode": "84653-5611",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "801-473-4385",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "2172 E 7200 S",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SPANISH FORK",
    "PracticeLocationAddressStateName": "UT",
    "PracticeLocationAddressPostalCode": "84660-9340",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "801-794-1218",
    "PracticeLocationAddressFaxNumber": "801-423-5304",
    "EnumerationDate": "05/05/2025",
    "LastUpdateDate": "05/05/2025",
    "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": "12324573-3102",
        "LicenseNumberStateCode": "UT",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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