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1952315582 NPI number — MARY KAY GAWNE APN

NPI Number: 1952315582
Health Care Provider/Practitioner: MARY KAY GAWNE APN

Information about “1952315582” NPI (MARY KAY GAWNE APN) exists in 1952315582 in HTML format HTML  |  1952315582 in plain Text format TXT  |  1952315582 in PDF (Portable Document Format) PDF  |  1952315582 in an XML format XML  formats.

NPI Number : 1952315582 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1952315582",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "GAWNE",
    "FirstName": "MARY",
    "MiddleName": "KAY",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "APN",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "BARRON",
    "OtherFirstName": "MARY",
    "OtherMiddleName": "KAY",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "APN, CNP",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "20 S CLARK ST",
    "SecondLineMailingAddress": "SUITE 1100",
    "MailingAddressCityName": "CHICAGO",
    "MailingAddressStateName": "IL",
    "MailingAddressPostalCode": "60603-1802",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "20 S CLARK ST",
    "SecondLinePracticeLocationAddress": "SUITE 1100",
    "PracticeLocationAddressCityName": "CHICAGO",
    "PracticeLocationAddressStateName": "IL",
    "PracticeLocationAddressPostalCode": "60603-1802",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "312-926-7443",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "07/28/2006",
    "LastUpdateDate": "04/10/2018",
    "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": "209-001604",
        "LicenseNumberStateCode": "IL",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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