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1881415537 NPI number — MELISSA DUARTE FNP-C

NPI Number: 1881415537
Health Care Provider/Practitioner: MELISSA DUARTE FNP-C

Information about “1881415537” NPI (MELISSA DUARTE FNP-C) exists in 1881415537 in HTML format HTML  |  1881415537 in plain Text format TXT  |  1881415537 in PDF (Portable Document Format) PDF  |  1881415537 in an XML format XML  formats.

NPI Number : 1881415537 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1881415537",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "DUARTE",
    "FirstName": "MELISSA",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "FNP-C",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "SANCHEZ",
    "OtherFirstName": "MELISSA",
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "5",
    "FirstLineMailingAddress": "517 W 159TH PL",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "GARDENA",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "90248-2413",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "323-702-7949",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "3450 WILSHIRE BLVD STE 1118",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LOS ANGELES",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "90010-2227",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "213-465-2643",
    "PracticeLocationAddressFaxNumber": "213-232-4944",
    "EnumerationDate": "10/24/2024",
    "LastUpdateDate": "12/21/2024",
    "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": "363LF0000X",
        "TaxonomyName": "Family Nurse Practitioner",
        "LicenseNumber": "95033154",
        "LicenseNumberStateCode": "CA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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