NPI Code Detail JSON Logo

1710142799 NPI number — DEBORA A BOUCHER APRN-FPA, CNM

NPI Number: 1710142799
Health Care Provider/Practitioner: DEBORA A BOUCHER APRN-FPA, CNM

Information about “1710142799” NPI (DEBORA A BOUCHER APRN-FPA, CNM) exists in 1710142799 in HTML format HTML  |  1710142799 in plain Text format TXT  |  1710142799 in PDF (Portable Document Format) PDF  |  1710142799 in an XML format XML  formats.

NPI Number : 1710142799 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1710142799",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BOUCHER",
    "FirstName": "DEBORA",
    "MiddleName": "A",
    "NamePrefix": "MS.",
    "NameSuffix": null,
    "Credential": "APRN-FPA, CNM",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "40826 N RIDGE CIR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "ANTIOCH",
    "MailingAddressStateName": "IL",
    "MailingAddressPostalCode": "60002-9545",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "847-975-7115",
    "MailingAddressFaxNumber": "888-959-0674",
    "FirstLinePracticeLocationAddress": "40826 N RIDGE CIR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "ANTIOCH",
    "PracticeLocationAddressStateName": "IL",
    "PracticeLocationAddressPostalCode": "60002-9545",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "847-975-7115",
    "PracticeLocationAddressFaxNumber": "888-959-0674",
    "EnumerationDate": "07/19/2008",
    "LastUpdateDate": "09/30/2023",
    "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": "367A00000X",
          "TaxonomyName": "Advanced Practice Midwife",
          "LicenseNumber": "209007144",
          "LicenseNumberStateCode": "IL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "367A00000X",
          "TaxonomyName": "Advanced Practice Midwife",
          "LicenseNumber": "277000293",
          "LicenseNumberStateCode": "IL",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "163W00000X",
          "TaxonomyName": "Registered Nurse",
          "LicenseNumber": "041.349335",
          "LicenseNumberStateCode": "IL",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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