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1508401696 NPI number — AMA B BOATENG PMHNP

NPI Number: 1508401696
Health Care Provider/Practitioner: AMA B BOATENG PMHNP

Information about “1508401696” NPI (AMA B BOATENG PMHNP) exists in 1508401696 in HTML format HTML  |  1508401696 in plain Text format TXT  |  1508401696 in PDF (Portable Document Format) PDF  |  1508401696 in an XML format XML  formats.

NPI Number : 1508401696 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1508401696",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BOATENG",
    "FirstName": "AMA",
    "MiddleName": "B",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "PMHNP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "521 N QUINCY ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "ARLINGTON",
    "MailingAddressStateName": "VA",
    "MailingAddressPostalCode": "22203-2136",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "703-841-0703",
    "MailingAddressFaxNumber": "571-297-9809",
    "FirstLinePracticeLocationAddress": "521 N QUINCY ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "ARLINGTON",
    "PracticeLocationAddressStateName": "VA",
    "PracticeLocationAddressPostalCode": "22203-2136",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "703-841-0703",
    "PracticeLocationAddressFaxNumber": "571-297-9809",
    "EnumerationDate": "11/12/2019",
    "LastUpdateDate": "06/25/2025",
    "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": "0024176694",
        "LicenseNumberStateCode": "VA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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