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1992456453 NPI number — ESSENCE NURSE LLC

NPI Number: 1992456453
Health Care Provider/Practitioner: ESSENCE NURSE LLC

Information about “1992456453” NPI (ESSENCE NURSE LLC) exists in 1992456453 in HTML format HTML  |  1992456453 in plain Text format TXT  |  1992456453 in PDF (Portable Document Format) PDF  |  1992456453 in an XML format XML  formats.

NPI Number : 1992456453 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1992456453",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "ESSENCE NURSE LLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "590 HIGHWAY 18 W",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "QUITMAN",
    "MailingAddressStateName": "MS",
    "MailingAddressPostalCode": "39355-8739",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "601-934-9629",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "590 HIGHWAY 18 W",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "QUITMAN",
    "PracticeLocationAddressStateName": "MS",
    "PracticeLocationAddressPostalCode": "39355-8739",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "601-934-9629",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "01/15/2022",
    "LastUpdateDate": "01/15/2022",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "GIBSON",
    "AuthorizedOfficialFirstName": "LAKISHA",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "OWNER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "RN",
    "AuthorizedOfficialTelephoneNumber": "601-934-9629",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "291U00000X",
        "TaxonomyName": "Clinical Medical Laboratory",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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