NPI Code Detail JSON Logo

1477364230 NPI number — JESSICA DUDLEY CNM

NPI Number: 1477364230
Health Care Provider/Practitioner: JESSICA DUDLEY CNM

Information about “1477364230” NPI (JESSICA DUDLEY CNM) exists in 1477364230 in HTML format HTML  |  1477364230 in plain Text format TXT  |  1477364230 in PDF (Portable Document Format) PDF  |  1477364230 in an XML format XML  formats.

NPI Number : 1477364230 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1477364230",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "DUDLEY",
    "FirstName": "JESSICA",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "CNM",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "8558 BROADWAY",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "MERRILLVILLE",
    "MailingAddressStateName": "IN",
    "MailingAddressPostalCode": "46410-7032",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "219-392-7086",
    "MailingAddressFaxNumber": "219-703-6854",
    "FirstLinePracticeLocationAddress": "100 W CHICAGO AVE STE F",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "EAST CHICAGO",
    "PracticeLocationAddressStateName": "IN",
    "PracticeLocationAddressPostalCode": "46312-3261",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "219-392-7016",
    "PracticeLocationAddressFaxNumber": "219-397-6904",
    "EnumerationDate": "01/20/2025",
    "LastUpdateDate": "03/17/2025",
    "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": "367A00000X",
          "TaxonomyName": "Advanced Practice Midwife",
          "LicenseNumber": "209.029607",
          "LicenseNumberStateCode": "IL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "367A00000X",
          "TaxonomyName": "Advanced Practice Midwife",
          "LicenseNumber": "09000489A",
          "LicenseNumberStateCode": "IN",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.