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1922494657 NPI number — CHRISTIAN CONSTANCE BLACKWELL RN MSN NP-C

NPI Number: 1922494657
Health Care Provider/Practitioner: CHRISTIAN CONSTANCE BLACKWELL RN MSN NP-C

Information about “1922494657” NPI (CHRISTIAN CONSTANCE BLACKWELL RN MSN NP-C) exists in 1922494657 in HTML format HTML  |  1922494657 in plain Text format TXT  |  1922494657 in PDF (Portable Document Format) PDF  |  1922494657 in an XML format XML  formats.

NPI Number : 1922494657 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1922494657",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BLACKWELL",
    "FirstName": "CHRISTIAN",
    "MiddleName": "CONSTANCE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "RN MSN NP-C",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "CARROLL",
    "OtherFirstName": "CHRISTIAN",
    "OtherMiddleName": "CONSTANCE",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "1005 MAR WALT DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "FORT WALTON BEACH",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "32547-6707",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "850-863-8100",
    "MailingAddressFaxNumber": "850-863-8548",
    "FirstLinePracticeLocationAddress": "1005 MAR WALT DRIVE",
    "SecondLinePracticeLocationAddress": "INTERNAL MEDICINE DEPARTMENT",
    "PracticeLocationAddressCityName": "FORT WALTON BEACH",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "32547-6707",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "850-863-8202",
    "PracticeLocationAddressFaxNumber": "850-862-6148",
    "EnumerationDate": "04/09/2015",
    "LastUpdateDate": "09/25/2019",
    "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": "363L00000X",
        "TaxonomyName": "Nurse Practitioner",
        "LicenseNumber": "APRN9171045",
        "LicenseNumberStateCode": "FL",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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