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1568513976 NPI number — SUELLEN O DRAKE APRN

NPI Number: 1568513976
Health Care Provider/Practitioner: SUELLEN O DRAKE APRN

Information about “1568513976” NPI (SUELLEN O DRAKE APRN) exists in 1568513976 in HTML format HTML  |  1568513976 in plain Text format TXT  |  1568513976 in PDF (Portable Document Format) PDF  |  1568513976 in an XML format XML  formats.

NPI Number : 1568513976 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1568513976",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "DRAKE",
    "FirstName": "SUELLEN",
    "MiddleName": "O",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "APRN",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "DRAKE",
    "OtherFirstName": "OLIVIA",
    "OtherMiddleName": "SUELLEN",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "ARNP",
    "OtherLastNameTypeCode": "5",
    "FirstLineMailingAddress": "PO BOX 924",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "DURHAM",
    "MailingAddressStateName": "NH",
    "MailingAddressPostalCode": "03824-0924",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "603-608-6192",
    "MailingAddressFaxNumber": "603-942-8194",
    "FirstLinePracticeLocationAddress": "13 JENKINS CT STE 247",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "DURHAM",
    "PracticeLocationAddressStateName": "NH",
    "PracticeLocationAddressPostalCode": "03824",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "603-942-5694",
    "PracticeLocationAddressFaxNumber": "603-942-8194",
    "EnumerationDate": "01/13/2007",
    "LastUpdateDate": "05/14/2018",
    "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": "04081123",
        "LicenseNumberStateCode": "NH",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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