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1437978509 NPI number — DEBRA JANET ROSEBROCK PTA

NPI Number: 1437978509
Health Care Provider/Practitioner: DEBRA JANET ROSEBROCK PTA

Information about “1437978509” NPI (DEBRA JANET ROSEBROCK PTA) exists in 1437978509 in HTML format HTML  |  1437978509 in plain Text format TXT  |  1437978509 in PDF (Portable Document Format) PDF  |  1437978509 in an XML format XML  formats.

NPI Number : 1437978509 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1437978509",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "ROSEBROCK",
    "FirstName": "DEBRA",
    "MiddleName": "JANET",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "PTA",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "ANDERSON",
    "OtherFirstName": "DEBRA",
    "OtherMiddleName": "JANET",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "PTA",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "4000 STATE ROAD 45",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "NASHVILLE",
    "MailingAddressStateName": "IN",
    "MailingAddressPostalCode": "47448-8246",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "317-796-2405",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "103 WILLOW ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "NASHVILLE",
    "PracticeLocationAddressStateName": "IN",
    "PracticeLocationAddressPostalCode": "47448-7604",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "812-988-3909",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "10/07/2024",
    "LastUpdateDate": "10/07/2024",
    "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": "225200000X",
        "TaxonomyName": "Physical Therapy Assistant",
        "LicenseNumber": "06001776A",
        "LicenseNumberStateCode": "IN",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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