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1669960274 NPI number — MICHELLE DEDON FNP

NPI Number: 1669960274
Health Care Provider/Practitioner: MICHELLE DEDON FNP

Information about “1669960274” NPI (MICHELLE DEDON FNP) exists in 1669960274 in HTML format HTML  |  1669960274 in plain Text format TXT  |  1669960274 in PDF (Portable Document Format) PDF  |  1669960274 in an XML format XML  formats.

NPI Number : 1669960274 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1669960274",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "DEDON",
    "FirstName": "MICHELLE",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "FNP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "360 US HIGHWAY 1 BYP UNIT 102",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "PORTSMOUTH",
    "MailingAddressStateName": "NH",
    "MailingAddressPostalCode": "03801-7105",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "603-410-6700",
    "MailingAddressFaxNumber": "603-309-9601",
    "FirstLinePracticeLocationAddress": "471 CENTER ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LUDLOW",
    "PracticeLocationAddressStateName": "MA",
    "PracticeLocationAddressPostalCode": "01056-2733",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "413-625-3500",
    "PracticeLocationAddressFaxNumber": "413-625-3655",
    "EnumerationDate": "04/30/2018",
    "LastUpdateDate": "11/26/2024",
    "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": "RN262213",
          "LicenseNumberStateCode": "MA",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "163W00000X",
          "TaxonomyName": "Registered Nurse",
          "LicenseNumber": "262213",
          "LicenseNumberStateCode": "MA",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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