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1609720887 NPI number — MRS. PAYTON BROOK PHILLIPS

NPI Number: 1609720887
Health Care Provider/Practitioner: MRS. PAYTON BROOK PHILLIPS

Information about “1609720887” NPI (MRS. PAYTON BROOK PHILLIPS) exists in 1609720887 in HTML format HTML  |  1609720887 in plain Text format TXT  |  1609720887 in PDF (Portable Document Format) PDF  |  1609720887 in an XML format XML  formats.

NPI Number : 1609720887 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1609720887",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "PHILLIPS",
    "FirstName": "PAYTON",
    "MiddleName": "BROOK",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "3125 AL HIGHWAY 168",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BOAZ",
    "MailingAddressStateName": "AL",
    "MailingAddressPostalCode": "35957-3878",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "38 ROWE DR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "GUNTERSVILLE",
    "PracticeLocationAddressStateName": "AL",
    "PracticeLocationAddressPostalCode": "35976-7367",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "256-571-8460",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "02/24/2026",
    "LastUpdateDate": "02/24/2026",
    "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": "363LP2300X",
        "TaxonomyName": "Primary Care Nurse Practitioner",
        "LicenseNumber": "1-179413",
        "LicenseNumberStateCode": "AL",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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