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1508294505 NPI number — BRENDA LEE BROWN FNP-C

NPI Number: 1508294505
Health Care Provider/Practitioner: BRENDA LEE BROWN FNP-C

Information about “1508294505” NPI (BRENDA LEE BROWN FNP-C) exists in 1508294505 in HTML format HTML  |  1508294505 in plain Text format TXT  |  1508294505 in PDF (Portable Document Format) PDF  |  1508294505 in an XML format XML  formats.

NPI Number : 1508294505 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1508294505",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BROWN",
    "FirstName": "BRENDA",
    "MiddleName": "LEE",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "FNP-C",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "BROWN",
    "OtherFirstName": "BRENDA",
    "OtherMiddleName": "MCREYNOLDS",
    "OtherNamePrefix": "MRS.",
    "OtherNameSuffix": null,
    "OtherCredential": "FNP-C",
    "OtherLastNameTypeCode": "2",
    "FirstLineMailingAddress": "46 SERGEANT PRENTISS DR",
    "SecondLineMailingAddress": "SUITE 201A",
    "MailingAddressCityName": "NATCHEZ",
    "MailingAddressStateName": "MS",
    "MailingAddressPostalCode": "39120-4792",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "601-445-2248",
    "MailingAddressFaxNumber": "601-445-3533",
    "FirstLinePracticeLocationAddress": "46 SERGEANT PRENTISS DR",
    "SecondLinePracticeLocationAddress": "SUITE 201A",
    "PracticeLocationAddressCityName": "NATCHEZ",
    "PracticeLocationAddressStateName": "MS",
    "PracticeLocationAddressPostalCode": "39120-4792",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "601-445-2248",
    "PracticeLocationAddressFaxNumber": "601-445-3533",
    "EnumerationDate": "10/29/2013",
    "LastUpdateDate": "03/01/2017",
    "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": "363LF0000X",
        "TaxonomyName": "Family Nurse Practitioner",
        "LicenseNumber": "R862378",
        "LicenseNumberStateCode": "MS",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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