NPI Code Detail JSON Logo

1508445511 NPI number — BRANDY M PROTZ PA -C

NPI Number: 1508445511
Health Care Provider/Practitioner: BRANDY M PROTZ PA -C

Information about “1508445511” NPI (BRANDY M PROTZ PA -C) exists in 1508445511 in HTML format HTML  |  1508445511 in plain Text format TXT  |  1508445511 in PDF (Portable Document Format) PDF  |  1508445511 in an XML format XML  formats.

NPI Number : 1508445511 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1508445511",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "PROTZ",
    "FirstName": "BRANDY",
    "MiddleName": "M",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "PA -C",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "12428 OLD MERIDIAN ST UNIT 211",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CARMEL",
    "MailingAddressStateName": "IN",
    "MailingAddressPostalCode": "46032-6114",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "618-339-4464",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "11900 N PENN ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "CARMEL",
    "PracticeLocationAddressStateName": "IN",
    "PracticeLocationAddressPostalCode": "46032-4693",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "317-663-7123",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "04/06/2021",
    "LastUpdateDate": "04/06/2021",
    "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": "363AM0700X",
        "TaxonomyName": "Medical Physician Assistant",
        "LicenseNumber": "10003236A",
        "LicenseNumberStateCode": "IN",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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