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1629023130 NPI number — ELVIRA GARRUCHO COOLEY

NPI Number: 1629023130
Health Care Provider/Practitioner: ELVIRA GARRUCHO COOLEY

Information about “1629023130” NPI (ELVIRA GARRUCHO COOLEY) exists in 1629023130 in HTML format HTML  |  1629023130 in plain Text format TXT  |  1629023130 in PDF (Portable Document Format) PDF  |  1629023130 in an XML format XML  formats.

NPI Number : 1629023130 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1629023130",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "X",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "COOLEY",
    "FirstName": "ELVIRA",
    "MiddleName": "GARRUCHO",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "GARRUCHO",
    "OtherFirstName": "ELVIRA",
    "OtherMiddleName": "DIONELA",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "ADULT NURSE PRACTITI",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "EVANS ARMY COMMUNITY HOSPITAL(EACH)USA MEDDAC",
    "SecondLineMailingAddress": "BLDG 7600,1650 COCHRANE CIRCLE,ATTN: CREDENTIALS OFFICE",
    "MailingAddressCityName": "FT CARSON",
    "MailingAddressStateName": "CO",
    "MailingAddressPostalCode": "80913-4604",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "719-526-7844",
    "MailingAddressFaxNumber": "719-526-7984",
    "FirstLinePracticeLocationAddress": "EVANS ARMY COMMUNITY HOSPITAL(EACH) USA MEDDAC",
    "SecondLinePracticeLocationAddress": "BLDG 7600,1650COCHRANE CIRCLE,ICU",
    "PracticeLocationAddressCityName": "FORT CARSON",
    "PracticeLocationAddressStateName": "CO",
    "PracticeLocationAddressPostalCode": "80913-4604",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "719-526-7020",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "05/23/2006",
    "LastUpdateDate": "07/08/2007",
    "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": "363LA2200X",
        "TaxonomyName": "Adult Health Nurse Practitioner",
        "LicenseNumber": "92183",
        "LicenseNumberStateCode": "CO",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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