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1457142069 NPI number — CARLY JOSEPHINE BAVIER NP

NPI Number: 1457142069
Health Care Provider/Practitioner: CARLY JOSEPHINE BAVIER NP

Information about “1457142069” NPI (CARLY JOSEPHINE BAVIER NP) exists in 1457142069 in HTML format HTML  |  1457142069 in plain Text format TXT  |  1457142069 in PDF (Portable Document Format) PDF  |  1457142069 in an XML format XML  formats.

NPI Number : 1457142069 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1457142069",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BAVIER",
    "FirstName": "CARLY",
    "MiddleName": "JOSEPHINE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "NP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "106 E MAIN ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SPRING ARBOR",
    "MailingAddressStateName": "MI",
    "MailingAddressPostalCode": "49283-9701",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "3512 COOLIDGE RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "EAST LANSING",
    "PracticeLocationAddressStateName": "MI",
    "PracticeLocationAddressPostalCode": "48823-6376",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "877-587-4112",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "05/14/2025",
    "LastUpdateDate": "10/17/2025",
    "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": "363LP0808X",
          "TaxonomyName": "Psychiatric/Mental Health Nurse Practitioner",
          "LicenseNumber": "2025000785",
          "LicenseNumberStateCode": "MI",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "163W00000X",
          "TaxonomyName": "Registered Nurse",
          "LicenseNumber": "4704358831",
          "LicenseNumberStateCode": "MI",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "163WM0705X",
          "TaxonomyName": "Medical-Surgical Registered Nurse",
          "LicenseNumber": "83186615",
          "LicenseNumberStateCode": "MI",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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