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1811109432 NPI number — ANITA LOUISE SWANSON PT

NPI Number: 1811109432
Health Care Provider/Practitioner: ANITA LOUISE SWANSON PT

Information about “1811109432” NPI (ANITA LOUISE SWANSON PT) exists in 1811109432 in HTML format HTML  |  1811109432 in plain Text format TXT  |  1811109432 in PDF (Portable Document Format) PDF  |  1811109432 in an XML format XML  formats.

NPI Number : 1811109432 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1811109432",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "SWANSON",
    "FirstName": "ANITA",
    "MiddleName": "LOUISE",
    "NamePrefix": "MS.",
    "NameSuffix": null,
    "Credential": "PT",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "ADAMS",
    "OtherFirstName": "ANITA",
    "OtherMiddleName": "SWANSON",
    "OtherNamePrefix": "MRS.",
    "OtherNameSuffix": null,
    "OtherCredential": "PT",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "111 PARK DRIVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "FAYETTEVILLE",
    "MailingAddressStateName": "WV",
    "MailingAddressPostalCode": "25840",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "304-640-1019",
    "MailingAddressFaxNumber": "304-574-3643",
    "FirstLinePracticeLocationAddress": "111 FAYETTE AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "FAYETTEVILLE",
    "PracticeLocationAddressStateName": "WV",
    "PracticeLocationAddressPostalCode": "25840",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "304-574-1176",
    "PracticeLocationAddressFaxNumber": "304-574-3643",
    "EnumerationDate": "05/04/2007",
    "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": "225100000X",
          "TaxonomyName": "Physical Therapist",
          "LicenseNumber": "731",
          "LicenseNumberStateCode": "WV",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "225100000X",
          "TaxonomyName": "Physical Therapist",
          "LicenseNumber": "2578",
          "LicenseNumberStateCode": "MN",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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