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1861972358 NPI number — BROOKE DIANE LOVELESS-YATES CRNP

NPI Number: 1861972358
Health Care Provider/Practitioner: BROOKE DIANE LOVELESS-YATES CRNP

Information about “1861972358” NPI (BROOKE DIANE LOVELESS-YATES CRNP) exists in 1861972358 in HTML format HTML  |  1861972358 in plain Text format TXT  |  1861972358 in PDF (Portable Document Format) PDF  |  1861972358 in an XML format XML  formats.

NPI Number : 1861972358 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1861972358",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "LOVELESS-YATES",
    "FirstName": "BROOKE",
    "MiddleName": "DIANE",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "CRNP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "850 PETER BRYCE BLVD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "TUSCALOOSA",
    "MailingAddressStateName": "AL",
    "MailingAddressPostalCode": "35401-7457",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "205-348-1770",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "2371 HIGHWAY 78",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "DORA",
    "PracticeLocationAddressStateName": "AL",
    "PracticeLocationAddressPostalCode": "35062-5233",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "205-255-7052",
    "PracticeLocationAddressFaxNumber": "205-255-7053",
    "EnumerationDate": "08/15/2018",
    "LastUpdateDate": "08/02/2019",
    "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": "363LF0000X",
        "TaxonomyName": "Family Nurse Practitioner",
        "LicenseNumber": "1-111217",
        "LicenseNumberStateCode": "AL",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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