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1659635001 NPI number — MICHELLE ANNE BURCHETT

NPI Number: 1659635001
Health Care Provider/Practitioner: MICHELLE ANNE BURCHETT

Information about “1659635001” NPI (MICHELLE ANNE BURCHETT) exists in 1659635001 in HTML format HTML  |  1659635001 in plain Text format TXT  |  1659635001 in PDF (Portable Document Format) PDF  |  1659635001 in an XML format XML  formats.

NPI Number : 1659635001 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1659635001",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BURCHETT",
    "FirstName": "MICHELLE",
    "MiddleName": "ANNE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "DIFINI",
    "OtherFirstName": "MICHELLE",
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "126 JOHN ROLFE LN",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "WILLIAMSBURG",
    "MailingAddressStateName": "VA",
    "MailingAddressPostalCode": "23185-1412",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "914-262-3914",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "6425 RICHMOND RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "WILLIAMSBURG",
    "PracticeLocationAddressStateName": "VA",
    "PracticeLocationAddressPostalCode": "23188-7202",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "914-262-3914",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "06/30/2012",
    "LastUpdateDate": "02/15/2023",
    "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": "235Z00000X",
          "TaxonomyName": "Speech-Language Pathologist",
          "LicenseNumber": "2204000858",
          "LicenseNumberStateCode": "VA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "174400000X",
          "TaxonomyName": "Specialist",
          "LicenseNumber": "981004",
          "LicenseNumberStateCode": "NY",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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