NPI Code Detail JSON Logo

1629368311 NPI number — SANDRA ANN COFFEE LMT

NPI Number: 1629368311
Health Care Provider/Practitioner: SANDRA ANN COFFEE LMT

Information about “1629368311” NPI (SANDRA ANN COFFEE LMT) exists in 1629368311 in HTML format HTML  |  1629368311 in plain Text format TXT  |  1629368311 in PDF (Portable Document Format) PDF  |  1629368311 in an XML format XML  formats.

NPI Number : 1629368311 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1629368311",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "COFFEE",
    "FirstName": "SANDRA",
    "MiddleName": "ANN",
    "NamePrefix": "MS.",
    "NameSuffix": null,
    "Credential": "LMT",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "COFFEE",
    "OtherFirstName": "SANDY",
    "OtherMiddleName": "ANN",
    "OtherNamePrefix": "MS.",
    "OtherNameSuffix": null,
    "OtherCredential": "LMT",
    "OtherLastNameTypeCode": "5",
    "FirstLineMailingAddress": "64-5119 KALAKE ST",
    "SecondLineMailingAddress": "64-5119 KALAKE ST",
    "MailingAddressCityName": "KAMUELA",
    "MailingAddressStateName": "HI",
    "MailingAddressPostalCode": "96743-8201",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "808-885-6324",
    "MailingAddressFaxNumber": "808-885-6324",
    "FirstLinePracticeLocationAddress": "61-3616 KAWAIHAE RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "KAMUELA",
    "PracticeLocationAddressStateName": "HI",
    "PracticeLocationAddressPostalCode": "96743-9721",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "808-885-6324",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "04/14/2011",
    "LastUpdateDate": "04/14/2011",
    "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": "174400000X",
        "TaxonomyName": "Specialist",
        "LicenseNumber": "MAT5246",
        "LicenseNumberStateCode": "HI",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.