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1619205069 NPI number — SALLYE ANN MILEY PNP

NPI Number: 1619205069
Health Care Provider/Practitioner: SALLYE ANN MILEY PNP

Information about “1619205069” NPI (SALLYE ANN MILEY PNP) exists in 1619205069 in HTML format HTML  |  1619205069 in plain Text format TXT  |  1619205069 in PDF (Portable Document Format) PDF  |  1619205069 in an XML format XML  formats.

NPI Number : 1619205069 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1619205069",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MILEY",
    "FirstName": "SALLYE",
    "MiddleName": "ANN",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "PNP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "MILEY",
    "OtherFirstName": "SALLYE",
    "OtherMiddleName": null,
    "OtherNamePrefix": "MRS.",
    "OtherNameSuffix": null,
    "OtherCredential": "PNP",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "203 GORDON ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "UNION",
    "MailingAddressStateName": "MS",
    "MailingAddressPostalCode": "39365-2121",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "601-745-6244",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "9431 EASTSIDE DRIVE EXT STE E",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "NEWTON",
    "PracticeLocationAddressStateName": "MS",
    "PracticeLocationAddressPostalCode": "39345-8072",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "601-635-3435",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "11/23/2009",
    "LastUpdateDate": "11/14/2023",
    "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": "363LP0200X",
        "TaxonomyName": "Pediatric Nurse Practitioner",
        "LicenseNumber": "R869919",
        "LicenseNumberStateCode": "MS",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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