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1972120129 NPI number — JACQUELYN SCHNACKEL PORZUCEK APRN-CNP

NPI Number: 1972120129
Health Care Provider/Practitioner: JACQUELYN SCHNACKEL PORZUCEK APRN-CNP

Information about “1972120129” NPI (JACQUELYN SCHNACKEL PORZUCEK APRN-CNP) exists in 1972120129 in HTML format HTML  |  1972120129 in plain Text format TXT  |  1972120129 in PDF (Portable Document Format) PDF  |  1972120129 in an XML format XML  formats.

NPI Number : 1972120129 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1972120129",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "PORZUCEK",
    "FirstName": "JACQUELYN",
    "MiddleName": "SCHNACKEL",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "APRN-CNP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "SCHNACKEL",
    "OtherFirstName": "JACQUELYN",
    "OtherMiddleName": "FAIN",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "APRN-CNP",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "111 COLCHESTER AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BURLINGTON",
    "MailingAddressStateName": "VT",
    "MailingAddressPostalCode": "05401-1473",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "802-847-2370",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "111 COLCHESTER AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "BURLINGTON",
    "PracticeLocationAddressStateName": "VT",
    "PracticeLocationAddressPostalCode": "05401-1473",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "802-847-2370",
    "PracticeLocationAddressFaxNumber": "802-847-8590",
    "EnumerationDate": "07/02/2020",
    "LastUpdateDate": "04/08/2025",
    "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": "163WN0002X",
          "TaxonomyName": "Neonatal Intensive Care Registered Nurse",
          "LicenseNumber": "026.0152967",
          "LicenseNumberStateCode": "VT",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LN0000X",
          "TaxonomyName": "Neonatal Nurse Practitioner",
          "LicenseNumber": "101.0136923",
          "LicenseNumberStateCode": "VT",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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