Individual Professional Information |
|
NPI
|
1568517845
|
|
Unique healthcare provider (clinician) ID assigned by NPPES
|
|
PECOS UID
|
0143480251
|
|
Unique individual clinician ID assigned by PECOS
|
|
Professional Enrollment ID
|
I20120328000080
|
|
Unique ID for the individual professional enrollment that is the source for the data in the observation
|
|
Provider Last Name
|
AVERY
|
|
Individual professional last name
|
|
Provider First Name
|
KATHRYN
|
|
Individual professional first name
|
|
Provider Middle Name
|
J
|
|
Individual professional middle name
|
|
Provider Gender
|
F
|
|
The provider's gender if the provider is a person.
|