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1891326872 NPI number — BEVHION BEATRIX BOUDICA FNP

NPI Number: 1891326872
Health Care Provider/Practitioner: BEVHION BEATRIX BOUDICA FNP

Information about “1891326872” NPI (BEVHION BEATRIX BOUDICA FNP) exists in 1891326872 in HTML format HTML  |  1891326872 in plain Text format TXT  |  1891326872 in PDF (Portable Document Format) PDF  |  1891326872 in an XML format XML  formats.

NPI Number : 1891326872 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1891326872",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BOUDICA",
    "FirstName": "BEVHION",
    "MiddleName": "BEATRIX",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "FNP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "BEASLEY",
    "OtherFirstName": "JESSICA",
    "OtherMiddleName": "RENEE",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "RN",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "2323 E GREENLAW LN STE 7B",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "FLAGSTAFF",
    "MailingAddressStateName": "AZ",
    "MailingAddressPostalCode": "86004-1849",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "928-863-6673",
    "MailingAddressFaxNumber": "928-222-2285",
    "FirstLinePracticeLocationAddress": "2323 E GREENLAW LN STE 7B",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "FLAGSTAFF",
    "PracticeLocationAddressStateName": "AZ",
    "PracticeLocationAddressPostalCode": "86004-1849",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "928-863-6673",
    "PracticeLocationAddressFaxNumber": "928-222-2285",
    "EnumerationDate": "01/29/2020",
    "LastUpdateDate": "06/16/2023",
    "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": "270276",
        "LicenseNumberStateCode": "AZ",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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