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1437342946 NPI number — SALLY DUANN VANDERSLICE R.PH., BCNP, FAPHA

NPI Number: 1437342946
Health Care Provider/Practitioner: SALLY DUANN VANDERSLICE R.PH., BCNP, FAPHA

Information about “1437342946” NPI (SALLY DUANN VANDERSLICE R.PH., BCNP, FAPHA) exists in 1437342946 in HTML format HTML  |  1437342946 in plain Text format TXT  |  1437342946 in PDF (Portable Document Format) PDF  |  1437342946 in an XML format XML  formats.

NPI Number : 1437342946 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1437342946",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "VANDERSLICE",
    "FirstName": "SALLY",
    "MiddleName": "DUANN",
    "NamePrefix": "MS.",
    "NameSuffix": null,
    "Credential": "R.PH., BCNP, FAPHA",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "3601 MORGANTOWN INDUSTRIAL PARK",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "MORGANTOWN",
    "MailingAddressStateName": "WV",
    "MailingAddressPostalCode": "26501-2346",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "304-215-3512",
    "MailingAddressFaxNumber": "304-292-8642",
    "FirstLinePracticeLocationAddress": "3601 MORGANTOWN INDUSTRIAL PARK",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "MORGANTOWN",
    "PracticeLocationAddressStateName": "WV",
    "PracticeLocationAddressPostalCode": "26501-2346",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "304-215-3512",
    "PracticeLocationAddressFaxNumber": "304-292-8642",
    "EnumerationDate": "08/20/2007",
    "LastUpdateDate": "08/20/2007",
    "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": "183500000X",
          "TaxonomyName": "Pharmacist",
          "LicenseNumber": "PS 30248",
          "LicenseNumberStateCode": "FL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "1835N0905X",
          "TaxonomyName": "Nuclear Pharmacist",
          "LicenseNumber": "RP0007024",
          "LicenseNumberStateCode": "WV",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "1835N0905X",
          "TaxonomyName": "Nuclear Pharmacist",
          "LicenseNumber": "03-1-20943",
          "LicenseNumberStateCode": "OH",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "1835N0905X",
          "TaxonomyName": "Nuclear Pharmacist",
          "LicenseNumber": "12921",
          "LicenseNumberStateCode": "MD",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "1835N0905X",
          "TaxonomyName": "Nuclear Pharmacist",
          "LicenseNumber": "26017733",
          "LicenseNumberStateCode": "IN",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "1835N0905X",
          "TaxonomyName": "Nuclear Pharmacist",
          "LicenseNumber": "0202011669",
          "LicenseNumberStateCode": "VA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "1835N0905X",
          "TaxonomyName": "Nuclear Pharmacist",
          "LicenseNumber": "2001014313",
          "LicenseNumberStateCode": "MO",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "1835N0905X",
          "TaxonomyName": "Nuclear Pharmacist",
          "LicenseNumber": "RP046130R",
          "LicenseNumberStateCode": "PA",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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