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1689469231 NPI number — KYLA MICHELLE BANCROFT

NPI Number: 1689469231
Health Care Provider/Practitioner: KYLA MICHELLE BANCROFT

Information about “1689469231” NPI (KYLA MICHELLE BANCROFT) exists in 1689469231 in HTML format HTML  |  1689469231 in plain Text format TXT  |  1689469231 in PDF (Portable Document Format) PDF  |  1689469231 in an XML format XML  formats.

NPI Number : 1689469231 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1689469231",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BANCROFT",
    "FirstName": "KYLA",
    "MiddleName": "MICHELLE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "HAFERT",
    "OtherFirstName": "KYLA",
    "OtherMiddleName": "MICHELLE",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "1201 N PINAL AVE STE A",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CASA GRANDE",
    "MailingAddressStateName": "AZ",
    "MailingAddressPostalCode": "85122-3336",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "520-494-2242",
    "MailingAddressFaxNumber": "623-265-6163",
    "FirstLinePracticeLocationAddress": "1201 N PINAL AVE STE A",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "CASA GRANDE",
    "PracticeLocationAddressStateName": "AZ",
    "PracticeLocationAddressPostalCode": "85122-3336",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "520-494-2242",
    "PracticeLocationAddressFaxNumber": "623-265-6163",
    "EnumerationDate": "04/14/2025",
    "LastUpdateDate": "04/14/2025",
    "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": "237700000X",
        "TaxonomyName": "Hearing Instrument Specialist",
        "LicenseNumber": "HADE16073",
        "LicenseNumberStateCode": "AZ",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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