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1932422896 NPI number — JEANELLE MARIE BRADSHAW D.C.

NPI Number: 1932422896
Health Care Provider/Practitioner: JEANELLE MARIE BRADSHAW D.C.

Information about “1932422896” NPI (JEANELLE MARIE BRADSHAW D.C.) exists in 1932422896 in HTML format HTML  |  1932422896 in plain Text format TXT  |  1932422896 in PDF (Portable Document Format) PDF  |  1932422896 in an XML format XML  formats.

NPI Number : 1932422896 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1932422896",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BRADSHAW",
    "FirstName": "JEANELLE",
    "MiddleName": "MARIE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "D.C.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "35979 BELL RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "ROUND HILL",
    "MailingAddressStateName": "VA",
    "MailingAddressPostalCode": "20141-2442",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "37-239-3557",
    "MailingAddressFaxNumber": "888-792-7952",
    "FirstLinePracticeLocationAddress": "602 S KING ST STE 301",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LEESBURG",
    "PracticeLocationAddressStateName": "VA",
    "PracticeLocationAddressPostalCode": "20175-3919",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "703-723-9355",
    "PracticeLocationAddressFaxNumber": "888-792-7952",
    "EnumerationDate": "03/08/2010",
    "LastUpdateDate": "03/13/2021",
    "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": "111N00000X",
        "TaxonomyName": "Chiropractor",
        "LicenseNumber": "0104556766",
        "LicenseNumberStateCode": "VA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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