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1699418228 NPI number — HEIDI J PRUETT

NPI Number: 1699418228
Health Care Provider/Practitioner: HEIDI J PRUETT

Information about “1699418228” NPI (HEIDI J PRUETT) exists in 1699418228 in HTML format HTML  |  1699418228 in plain Text format TXT  |  1699418228 in PDF (Portable Document Format) PDF  |  1699418228 in an XML format XML  formats.

NPI Number : 1699418228 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1699418228",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "PRUETT",
    "FirstName": "HEIDI",
    "MiddleName": "J",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "PAFF",
    "OtherFirstName": "HEIDI",
    "OtherMiddleName": "J",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "PO BOX 11407, DEPARTMENT 8007",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BIRMINGHAM",
    "MailingAddressStateName": "AL",
    "MailingAddressPostalCode": "35246-8007",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "205-631-5521",
    "MailingAddressFaxNumber": "205-631-5540",
    "FirstLinePracticeLocationAddress": "430 FIELDSTOWN RD STE 104",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "GARDENDALE",
    "PracticeLocationAddressStateName": "AL",
    "PracticeLocationAddressPostalCode": "35071-2458",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "205-631-5521",
    "PracticeLocationAddressFaxNumber": "205-631-5540",
    "EnumerationDate": "04/20/2022",
    "LastUpdateDate": "01/02/2026",
    "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": "363LG0600X",
          "TaxonomyName": "Gerontology Nurse Practitioner",
          "LicenseNumber": "1-075629",
          "LicenseNumberStateCode": "AL",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "363LA2200X",
          "TaxonomyName": "Adult Health Nurse Practitioner",
          "LicenseNumber": "1-075629",
          "LicenseNumberStateCode": "AL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LP2300X",
          "TaxonomyName": "Primary Care Nurse Practitioner",
          "LicenseNumber": "1-075629",
          "LicenseNumberStateCode": "AL",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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