NPI Code Detail JSON Logo

1619413275 NPI number — AMANDA PAIGE DAVIS CRNP

NPI Number: 1619413275
Health Care Provider/Practitioner: AMANDA PAIGE DAVIS CRNP

Information about “1619413275” NPI (AMANDA PAIGE DAVIS CRNP) exists in 1619413275 in HTML format HTML  |  1619413275 in plain Text format TXT  |  1619413275 in PDF (Portable Document Format) PDF  |  1619413275 in an XML format XML  formats.

NPI Number : 1619413275 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1619413275",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "DAVIS",
    "FirstName": "AMANDA",
    "MiddleName": "PAIGE",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "CRNP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "DAVIS",
    "OtherFirstName": "AMANDA",
    "OtherMiddleName": "PAIGE",
    "OtherNamePrefix": "MRS.",
    "OtherNameSuffix": null,
    "OtherCredential": "CRNP",
    "OtherLastNameTypeCode": "2",
    "FirstLineMailingAddress": "1010 1ST ST N",
    "SecondLineMailingAddress": "STE 112",
    "MailingAddressCityName": "ALABASTER",
    "MailingAddressStateName": "AL",
    "MailingAddressPostalCode": "35007-8621",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "205-663-1023",
    "MailingAddressFaxNumber": "205-423-0416",
    "FirstLinePracticeLocationAddress": "270 VILLAGE PKWY",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "HELENA",
    "PracticeLocationAddressStateName": "AL",
    "PracticeLocationAddressPostalCode": "35080-4040",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "205-664-9430",
    "PracticeLocationAddressFaxNumber": "205-664-1846",
    "EnumerationDate": "01/06/2017",
    "LastUpdateDate": "07/21/2017",
    "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": "1-104301",
        "LicenseNumberStateCode": "AL",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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