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1417815523 NPI number — MRS. MISTY DAWN BLANTON

NPI Number: 1417815523
Health Care Provider/Practitioner: MRS. MISTY DAWN BLANTON

Information about “1417815523” NPI (MRS. MISTY DAWN BLANTON) exists in 1417815523 in HTML format HTML  |  1417815523 in plain Text format TXT  |  1417815523 in PDF (Portable Document Format) PDF  |  1417815523 in an XML format XML  formats.

NPI Number : 1417815523 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1417815523",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BLANTON",
    "FirstName": "MISTY",
    "MiddleName": "DAWN",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "CARTER",
    "OtherFirstName": "MISTY",
    "OtherMiddleName": "DAWN",
    "OtherNamePrefix": "MS.",
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "1769 TRI COUNTY HWY",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "WILLIAMSBURG",
    "MailingAddressStateName": "OH",
    "MailingAddressPostalCode": "45176-9208",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "180-058-2727",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "123 W MAIN ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "WEST UNION",
    "PracticeLocationAddressStateName": "OH",
    "PracticeLocationAddressPostalCode": "45693-1303",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "180-058-2727",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "01/15/2026",
    "LastUpdateDate": "01/15/2026",
    "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": "374U00000X",
        "TaxonomyName": "Home Health Aide",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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