NPI Code Detail JSON Logo

1750013850 NPI number — NERISSA A HOLDEN COSMETOLOGIST

NPI Number: 1750013850
Health Care Provider/Practitioner: NERISSA A HOLDEN COSMETOLOGIST

Information about “1750013850” NPI (NERISSA A HOLDEN COSMETOLOGIST) exists in 1750013850 in HTML format HTML  |  1750013850 in plain Text format TXT  |  1750013850 in PDF (Portable Document Format) PDF  |  1750013850 in an XML format XML  formats.

NPI Number : 1750013850 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1750013850",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "HOLDEN",
    "FirstName": "NERISSA",
    "MiddleName": "A",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "COSMETOLOGIST",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "7604 CEDAR TREE LN",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CHARLOTTE",
    "MailingAddressStateName": "NC",
    "MailingAddressPostalCode": "28227-1246",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "704-777-7292",
    "MailingAddressFaxNumber": "980-236-8209",
    "FirstLinePracticeLocationAddress": "7604 CEDAR TREE LN",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "CHARLOTTE",
    "PracticeLocationAddressStateName": "NC",
    "PracticeLocationAddressPostalCode": "28227-1246",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "704-777-7292",
    "PracticeLocationAddressFaxNumber": "980-236-8209",
    "EnumerationDate": "06/28/2022",
    "LastUpdateDate": "04/02/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": "10/27/2022",
    "NPIReactivationDate": "11/01/2022",
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "335E00000X",
        "TaxonomyName": "Prosthetic/Orthotic Supplier",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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