NPI Code Detail JSON Logo

1760121420 NPI number — COURTNEE RAE MOYLE LMT

NPI Number: 1760121420
Health Care Provider/Practitioner: COURTNEE RAE MOYLE LMT

Information about “1760121420” NPI (COURTNEE RAE MOYLE LMT) exists in 1760121420 in HTML format HTML  |  1760121420 in plain Text format TXT  |  1760121420 in PDF (Portable Document Format) PDF  |  1760121420 in an XML format XML  formats.

NPI Number : 1760121420 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1760121420",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MOYLE",
    "FirstName": "COURTNEE",
    "MiddleName": "RAE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "LMT",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "508 SMITH ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "COTTONWOOD",
    "MailingAddressStateName": "ID",
    "MailingAddressPostalCode": "83522-6003",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "208-790-8759",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "THE GYM",
    "SecondLinePracticeLocationAddress": "1005 ID-13",
    "PracticeLocationAddressCityName": "GRANGEVILLE",
    "PracticeLocationAddressStateName": "ID",
    "PracticeLocationAddressPostalCode": "83530",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "208-790-8759",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "06/01/2022",
    "LastUpdateDate": "06/01/2022",
    "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": "225700000X",
        "TaxonomyName": "Massage Therapist",
        "LicenseNumber": "MAS-4748",
        "LicenseNumberStateCode": "ID",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.