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1497000657 NPI number — MELISSA MARTIN BREAUX FNP-C

NPI Number: 1497000657
Health Care Provider/Practitioner: MELISSA MARTIN BREAUX FNP-C

Information about “1497000657” NPI (MELISSA MARTIN BREAUX FNP-C) exists in 1497000657 in HTML format HTML  |  1497000657 in plain Text format TXT  |  1497000657 in PDF (Portable Document Format) PDF  |  1497000657 in an XML format XML  formats.

NPI Number : 1497000657 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1497000657",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BREAUX",
    "FirstName": "MELISSA",
    "MiddleName": "MARTIN",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "FNP-C",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "MILLER",
    "OtherFirstName": "MELISSA",
    "OtherMiddleName": "JANE",
    "OtherNamePrefix": "MRS.",
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "1233 WAYNE GILMORE CIRCLE",
    "SecondLineMailingAddress": "STE 250-B",
    "MailingAddressCityName": "OPELOUSAS",
    "MailingAddressStateName": "LA",
    "MailingAddressPostalCode": "70570-6405",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "337-407-1955",
    "MailingAddressFaxNumber": "337-407-1956",
    "FirstLinePracticeLocationAddress": "1233 WAYNE GILMORE CIRCLE",
    "SecondLinePracticeLocationAddress": "SUITE 250-B",
    "PracticeLocationAddressCityName": "OPELOUSAS",
    "PracticeLocationAddressStateName": "LA",
    "PracticeLocationAddressPostalCode": "70570-6405",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "337-407-1955",
    "PracticeLocationAddressFaxNumber": "337-407-1956",
    "EnumerationDate": "07/13/2012",
    "LastUpdateDate": "06/20/2013",
    "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": "363L00000X",
        "TaxonomyName": "Nurse Practitioner",
        "LicenseNumber": "RN063199/AP06875",
        "LicenseNumberStateCode": "LA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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