1124059530 NPI number — LARRY EUGENE KERSCHNER A.R.N.P.

NPI Number: 1124059530
Health Care Provider/Practitioner: LARRY EUGENE KERSCHNER A.R.N.P.

NPI Number : 1124059530 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1124059530",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "KERSCHNER",
    "FirstName": "LARRY",
    "MiddleName": "EUGENE",
    "NamePrefix": "MR.",
    "NameSuffix": null,
    "Credential": "A.R.N.P.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "PO BOX 158",
    "SecondLineMailingAddress": "402 NORTH MAIN STREET",
    "MailingAddressCityName": "PE ELL",
    "MailingAddressStateName": "WA",
    "MailingAddressPostalCode": "98572-0158",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "360-291-3232",
    "MailingAddressFaxNumber": "360-291-3144",
    "FirstLinePracticeLocationAddress": "402 NORTH MAIN STREET",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "PE ELL",
    "PracticeLocationAddressStateName": "WA",
    "PracticeLocationAddressPostalCode": "98572-0158",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "360-291-3232",
    "PracticeLocationAddressFaxNumber": "360-291-3144",
    "EnumerationDate": "07/05/2006",
    "LastUpdateDate": "02/04/2008",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "363LF0000X",
        "TaxonomyName": "Family Nurse Practitioner",
        "LicenseNumber": "AP30001759",
        "LicenseNumberStateCode": "WA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}