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1699954040 NPI number — ERICKA FONTENOT SOILEAU PT, DPT

NPI Number: 1699954040
Health Care Provider/Practitioner: ERICKA FONTENOT SOILEAU PT, DPT

Information about “1699954040” NPI (ERICKA FONTENOT SOILEAU PT, DPT) exists in 1699954040 in HTML format HTML  |  1699954040 in plain Text format TXT  |  1699954040 in PDF (Portable Document Format) PDF  |  1699954040 in an XML format XML  formats.

NPI Number : 1699954040 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1699954040",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "SOILEAU",
    "FirstName": "ERICKA",
    "MiddleName": "FONTENOT",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "PT, DPT",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "FONTENOT",
    "OtherFirstName": "ERICKA",
    "OtherMiddleName": "LANE",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "PT, DPT",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "1200 CORPORATE DR STE 400",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "HOOVER",
    "MailingAddressStateName": "AL",
    "MailingAddressPostalCode": "35242-5424",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "423-238-7217",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "71121 HIGHWAY 21 APT D",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "COVINGTON",
    "PracticeLocationAddressStateName": "LA",
    "PracticeLocationAddressPostalCode": "70433-7176",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "985-898-3979",
    "PracticeLocationAddressFaxNumber": "985-898-3981",
    "EnumerationDate": "11/01/2007",
    "LastUpdateDate": "12/10/2020",
    "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": "225100000X",
        "TaxonomyName": "Physical Therapist",
        "LicenseNumber": "09195R",
        "LicenseNumberStateCode": "LA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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