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1861475204 NPI number — NANCY A ROE NP

NPI Number: 1861475204
Health Care Provider/Practitioner: NANCY A ROE NP

Information about “1861475204” NPI (NANCY A ROE NP) exists in 1861475204 in HTML format HTML  |  1861475204 in plain Text format TXT  |  1861475204 in PDF (Portable Document Format) PDF  |  1861475204 in an XML format XML  formats.

NPI Number : 1861475204 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1861475204",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "ROE",
    "FirstName": "NANCY",
    "MiddleName": "A",
    "NamePrefix": "MS.",
    "NameSuffix": null,
    "Credential": "NP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "540 CONSERVANCY WAY APT 106",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CHESAPEAKE",
    "MailingAddressStateName": "VA",
    "MailingAddressPostalCode": "23323-1334",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "669-411-8518",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "6477 COLLEGE PARK SQ STE 312",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "VIRGINIA BEACH",
    "PracticeLocationAddressStateName": "VA",
    "PracticeLocationAddressPostalCode": "23464-3611",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "757-452-6932",
    "PracticeLocationAddressFaxNumber": "757-905-4316",
    "EnumerationDate": "11/21/2005",
    "LastUpdateDate": "09/13/2024",
    "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": "363L00000X",
          "TaxonomyName": "Nurse Practitioner",
          "LicenseNumber": "453123",
          "LicenseNumberStateCode": "NY",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LA2200X",
          "TaxonomyName": "Adult Health Nurse Practitioner",
          "LicenseNumber": "A03703",
          "LicenseNumberStateCode": "VA",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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