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1003034216 NPI number — MRS. NANCY A SHIRK

NPI Number: 1003034216
Health Care Provider/Practitioner: MRS. NANCY A SHIRK

Information about “1003034216” NPI (MRS. NANCY A SHIRK) exists in 1003034216 in HTML format HTML  |  1003034216 in plain Text format TXT  |  1003034216 in PDF (Portable Document Format) PDF  |  1003034216 in an XML format XML  formats.

NPI Number : 1003034216 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1003034216",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "SHIRK",
    "FirstName": "NANCY",
    "MiddleName": "A",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "OLSON",
    "OtherFirstName": "NANCY",
    "OtherMiddleName": "A",
    "OtherNamePrefix": "MRS.",
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "8026 S 85TH ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "FRANKLIN",
    "MailingAddressStateName": "WI",
    "MailingAddressPostalCode": "53132-8571",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "414-425-4884",
    "MailingAddressFaxNumber": "414-525-2798",
    "FirstLinePracticeLocationAddress": "107 DIVISION ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "PLYMOUTH",
    "PracticeLocationAddressStateName": "WI",
    "PracticeLocationAddressPostalCode": "53073-1801",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "920-892-7788",
    "PracticeLocationAddressFaxNumber": "920-893-5459",
    "EnumerationDate": "04/23/2007",
    "LastUpdateDate": "07/08/2007",
    "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": "101YA0400X",
        "TaxonomyName": "Addiction (Substance Use Disorder) Counselor",
        "LicenseNumber": "962-132",
        "LicenseNumberStateCode": "WI",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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