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1811035777 NPI number — KATHRYN ANN HANAVAN RN MSN ANP

NPI Number: 1811035777
Health Care Provider/Practitioner: KATHRYN ANN HANAVAN RN MSN ANP

Information about “1811035777” NPI (KATHRYN ANN HANAVAN RN MSN ANP) exists in 1811035777 in HTML format HTML  |  1811035777 in plain Text format TXT  |  1811035777 in PDF (Portable Document Format) PDF  |  1811035777 in an XML format XML  formats.

NPI Number : 1811035777 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1811035777",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "HANAVAN",
    "FirstName": "KATHRYN",
    "MiddleName": "ANN",
    "NamePrefix": "MS.",
    "NameSuffix": null,
    "Credential": "RN MSN ANP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "14319 ORCHARD SPRINGS RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "LAKE OSWEGO",
    "MailingAddressStateName": "OR",
    "MailingAddressPostalCode": "97035-6541",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "503-699-7730",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "3181 SW SAM JACKSON PARK RD",
    "SecondLinePracticeLocationAddress": "OP05DC",
    "PracticeLocationAddressCityName": "PORTLAND",
    "PracticeLocationAddressStateName": "OR",
    "PracticeLocationAddressPostalCode": "97239-3011",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "503-494-8311",
    "PracticeLocationAddressFaxNumber": "503-494-4781",
    "EnumerationDate": "02/02/2007",
    "LastUpdateDate": "07/08/2007",
    "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": "363LA2200X",
        "TaxonomyName": "Adult Health Nurse Practitioner",
        "LicenseNumber": "079044074N3 ANP-PP",
        "LicenseNumberStateCode": "OR",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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