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1053563189 NPI number — STACEY MARIE MOSTEK MS, PLMHP

NPI Number: 1053563189
Health Care Provider/Practitioner: STACEY MARIE MOSTEK MS, PLMHP

Information about “1053563189” NPI (STACEY MARIE MOSTEK MS, PLMHP) exists in 1053563189 in HTML format HTML  |  1053563189 in plain Text format TXT  |  1053563189 in PDF (Portable Document Format) PDF  |  1053563189 in an XML format XML  formats.

NPI Number : 1053563189 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1053563189",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MOSTEK",
    "FirstName": "STACEY",
    "MiddleName": "MARIE",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "MS, PLMHP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "2102 W 37TH ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "KEARNEY",
    "MailingAddressStateName": "NE",
    "MailingAddressPostalCode": "68845-2219",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "402-380-0313",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "2041 E 56TH ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "KEARNEY",
    "PracticeLocationAddressStateName": "NE",
    "PracticeLocationAddressPostalCode": "68847-4179",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "308-236-7145",
    "PracticeLocationAddressFaxNumber": "308-236-7150",
    "EnumerationDate": "10/21/2008",
    "LastUpdateDate": "10/21/2008",
    "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": "101Y00000X",
        "TaxonomyName": "Counselor",
        "LicenseNumber": "8625",
        "LicenseNumberStateCode": "NE",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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