NPI Code Detail JSON Logo

1992301279 NPI number — COURTNEY LYNN PRUETT OT

NPI Number: 1992301279
Health Care Provider/Practitioner: COURTNEY LYNN PRUETT OT

Information about “1992301279” NPI (COURTNEY LYNN PRUETT OT) exists in 1992301279 in HTML format HTML  |  1992301279 in plain Text format TXT  |  1992301279 in PDF (Portable Document Format) PDF  |  1992301279 in an XML format XML  formats.

NPI Number : 1992301279 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1992301279",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "PRUETT",
    "FirstName": "COURTNEY",
    "MiddleName": "LYNN",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "OT",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "4309 OLD JACKSBORO HWY, ST 101",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "WICHITA FALLS",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "76302",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "940-386-1004",
    "MailingAddressFaxNumber": "940-386-9944",
    "FirstLinePracticeLocationAddress": "4309 OLD JACKSBORO HWY, ST 101",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "WICHITA FALLS",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "76302",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "940-386-1004",
    "PracticeLocationAddressFaxNumber": "940-386-9944",
    "EnumerationDate": "12/10/2020",
    "LastUpdateDate": "12/10/2020",
    "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": "225XP0200X",
        "TaxonomyName": "Pediatric Occupational Therapist",
        "LicenseNumber": "121325",
        "LicenseNumberStateCode": "TX",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.