NPI Code Detail JSON Logo

1124316278 NPI number — KATRINA J POTTER

NPI Number: 1124316278
Health Care Provider/Practitioner: KATRINA J POTTER

Information about “1124316278” NPI (KATRINA J POTTER) exists in 1124316278 in HTML format HTML  |  1124316278 in plain Text format TXT  |  1124316278 in PDF (Portable Document Format) PDF  |  1124316278 in an XML format XML  formats.

NPI Number : 1124316278 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1124316278",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "POTTER",
    "FirstName": "KATRINA",
    "MiddleName": "J",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "HILBERT",
    "OtherFirstName": "KATRINA",
    "OtherMiddleName": "J",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "113 WORTHY AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "MEDINA",
    "MailingAddressStateName": "NY",
    "MailingAddressPostalCode": "14103-1343",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "716-940-9916",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "113 WORTHY AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "MEDINA",
    "PracticeLocationAddressStateName": "NY",
    "PracticeLocationAddressPostalCode": "14103-1343",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "716-940-9916",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "07/11/2011",
    "LastUpdateDate": "03/18/2025",
    "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": "164W00000X",
        "TaxonomyName": "Licensed Practical Nurse",
        "LicenseNumber": "10300054",
        "LicenseNumberStateCode": "NY",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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