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1821170408 NPI number — KAREN GRAVES FARRELL NP

NPI Number: 1821170408
Health Care Provider/Practitioner: KAREN GRAVES FARRELL NP

Information about “1821170408” NPI (KAREN GRAVES FARRELL NP) exists in 1821170408 in HTML format HTML  |  1821170408 in plain Text format TXT  |  1821170408 in PDF (Portable Document Format) PDF  |  1821170408 in an XML format XML  formats.

NPI Number : 1821170408 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1821170408",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "FARRELL",
    "FirstName": "KAREN",
    "MiddleName": "GRAVES",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "NP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "P.O. BOX 1063",
    "SecondLineMailingAddress": "FAHC",
    "MailingAddressCityName": "BURLINGTON",
    "MailingAddressStateName": "VT",
    "MailingAddressPostalCode": "05402",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "111 COLCHESTER AVE",
    "SecondLinePracticeLocationAddress": "MCLURE 1 CARDIOLOGY",
    "PracticeLocationAddressCityName": "BURLINGTON",
    "PracticeLocationAddressStateName": "VT",
    "PracticeLocationAddressPostalCode": "05401-1473",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "802-847-3734",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "10/20/2006",
    "LastUpdateDate": "03/07/2011",
    "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": "363LA2100X",
          "TaxonomyName": "Acute Care Nurse Practitioner",
          "LicenseNumber": "101-0008425",
          "LicenseNumberStateCode": "VT",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "363LA2200X",
          "TaxonomyName": "Adult Health Nurse Practitioner",
          "LicenseNumber": "101-0008425",
          "LicenseNumberStateCode": "VT",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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