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1750645644 NPI number — MARCIE ELLEN KABLE PA

NPI Number: 1750645644
Health Care Provider/Practitioner: MARCIE ELLEN KABLE PA

Information about “1750645644” NPI (MARCIE ELLEN KABLE PA) exists in 1750645644 in HTML format HTML  |  1750645644 in plain Text format TXT  |  1750645644 in PDF (Portable Document Format) PDF  |  1750645644 in an XML format XML  formats.

NPI Number : 1750645644 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1750645644",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "KABLE",
    "FirstName": "MARCIE",
    "MiddleName": "ELLEN",
    "NamePrefix": "MS.",
    "NameSuffix": null,
    "Credential": "PA",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "SCHLAUD",
    "OtherFirstName": "MARCIE",
    "OtherMiddleName": "ELLEN",
    "OtherNamePrefix": "MS.",
    "OtherNameSuffix": null,
    "OtherCredential": "PA",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "1447 N HARRISON ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SAGINAW",
    "MailingAddressStateName": "MI",
    "MailingAddressPostalCode": "48602-4727",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "989-583-0000",
    "MailingAddressFaxNumber": "989-583-2811",
    "FirstLinePracticeLocationAddress": "1447 N HARRISON ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SAGINAW",
    "PracticeLocationAddressStateName": "MI",
    "PracticeLocationAddressPostalCode": "48602-4727",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "989-583-0000",
    "PracticeLocationAddressFaxNumber": "989-583-2811",
    "EnumerationDate": "06/26/2012",
    "LastUpdateDate": "03/26/2021",
    "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": "363A00000X",
        "TaxonomyName": "Physician Assistant",
        "LicenseNumber": "5601006345",
        "LicenseNumberStateCode": "MI",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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