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1063034924 NPI number — LINDSEY NELSON OD

NPI Number: 1063034924
Health Care Provider/Practitioner: LINDSEY NELSON OD

Information about “1063034924” NPI (LINDSEY NELSON OD) exists in 1063034924 in HTML format HTML  |  1063034924 in plain Text format TXT  |  1063034924 in PDF (Portable Document Format) PDF  |  1063034924 in an XML format XML  formats.

NPI Number : 1063034924 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1063034924",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "NELSON",
    "FirstName": "LINDSEY",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "OD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "LEWIS",
    "OtherFirstName": "LINDSEY",
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "DO",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "580 LAKES EDGE DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "OXFORD",
    "MailingAddressStateName": "MI",
    "MailingAddressPostalCode": "48371-5227",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "248-891-1349",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "116 N TUSCOLA RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "BAY CITY",
    "PracticeLocationAddressStateName": "MI",
    "PracticeLocationAddressPostalCode": "48708-6961",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "989-892-9595",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "05/14/2020",
    "LastUpdateDate": "08/15/2023",
    "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": "152W00000X",
        "TaxonomyName": "Optometrist",
        "LicenseNumber": "4901005445",
        "LicenseNumberStateCode": "MI",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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