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1689130239 NPI number — GABRIELLE GRACE CHANEY PT, DPT

NPI Number: 1689130239
Health Care Provider/Practitioner: GABRIELLE GRACE CHANEY PT, DPT

Information about “1689130239” NPI (GABRIELLE GRACE CHANEY PT, DPT) exists in 1689130239 in HTML format HTML  |  1689130239 in plain Text format TXT  |  1689130239 in PDF (Portable Document Format) PDF  |  1689130239 in an XML format XML  formats.

NPI Number : 1689130239 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1689130239",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "CHANEY",
    "FirstName": "GABRIELLE",
    "MiddleName": "GRACE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "PT, DPT",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "3041 W HORIZON RIDGE PKWY STE 140",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "HENDERSON",
    "MailingAddressStateName": "NV",
    "MailingAddressPostalCode": "89052-4445",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "702-565-6565",
    "MailingAddressFaxNumber": "702-565-8898",
    "FirstLinePracticeLocationAddress": "3041 W HORIZON RIDGE PKWY STE 140",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "HENDERSON",
    "PracticeLocationAddressStateName": "NV",
    "PracticeLocationAddressPostalCode": "89052-4445",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "702-565-6565",
    "PracticeLocationAddressFaxNumber": "702-565-8898",
    "EnumerationDate": "02/19/2019",
    "LastUpdateDate": "01/21/2026",
    "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": "2255A2300X",
          "TaxonomyName": "Athletic Trainer",
          "LicenseNumber": "AT0506827",
          "LicenseNumberStateCode": "NV",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "225100000X",
          "TaxonomyName": "Physical Therapist",
          "LicenseNumber": "6847",
          "LicenseNumberStateCode": "NV",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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