1891752366 NPI number — MRS. JOSEPHINE DC GARCIA APRN BC FNP-,DNP,MD

Table of content: MRS. JOSEPHINE DC GARCIA APRN BC FNP-,DNP,MD (NPI 1891752366)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891752366 NPI number — MRS. JOSEPHINE DC GARCIA APRN BC FNP-,DNP,MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GARCIA
Provider First Name:
JOSEPHINE
Provider Middle Name:
DC
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
APRN BC FNP-,DNP,MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GARCIA
Provider Other First Name:
JOSEPHINE
Provider Other Middle Name:
DC
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1891752366
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/29/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
102 MAIN AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HAYTI
Provider Business Mailing Address State Name:
SD
Provider Business Mailing Address Postal Code:
57241
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
605-783-2999
Provider Business Mailing Address Fax Number:
605-401-6942

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
102 MAIN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HAYTI
Provider Business Practice Location Address State Name:
SD
Provider Business Practice Location Address Postal Code:
57241
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
605-783-2999
Provider Business Practice Location Address Fax Number:
605-401-6942
Provider Enumeration Date:
04/28/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  609276 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: R188017-7 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: CP000771 , registered in the state of SD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 8N4070 . This is a "BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 163827201 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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