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1417890120 NPI number — AUDRA MONROE MORAN

NPI Number: 1417890120
Health Care Provider/Practitioner: AUDRA MONROE MORAN

Information about “1417890120” NPI (AUDRA MONROE MORAN) exists in 1417890120 in HTML format HTML  |  1417890120 in plain Text format TXT  |  1417890120 in PDF (Portable Document Format) PDF  |  1417890120 in an XML format XML  formats.

NPI Number : 1417890120 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1417890120",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MORAN",
    "FirstName": "AUDRA",
    "MiddleName": "MONROE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "HUFFORD",
    "OtherFirstName": "AUDRA",
    "OtherMiddleName": "MONROE",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "560 COHASSET RD STE 100",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CHICO",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "95926-2490",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "6589 JACK HILL DR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "OROVILLE",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "95966-3880",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "530-739-0502",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "04/09/2026",
    "LastUpdateDate": "04/09/2026",
    "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": "372600000X",
        "TaxonomyName": "Adult Companion",
        "LicenseNumber": null,
        "LicenseNumberStateCode": "CA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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