NPI Code Detail JSON Logo

1124363049 NPI number — KRISTYN THIELEN APRN

NPI Number: 1124363049
Health Care Provider/Practitioner: KRISTYN THIELEN APRN

Information about “1124363049” NPI (KRISTYN THIELEN APRN) exists in 1124363049 in HTML format HTML  |  1124363049 in plain Text format TXT  |  1124363049 in PDF (Portable Document Format) PDF  |  1124363049 in an XML format XML  formats.

NPI Number : 1124363049 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1124363049",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "THIELEN",
    "FirstName": "KRISTYN",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "APRN",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "217 S CATHERINE AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "LA GRANGE",
    "MailingAddressStateName": "IL",
    "MailingAddressPostalCode": "60525-2313",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "630-667-7123",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "2650 RIDGE AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "EVANSTON",
    "PracticeLocationAddressStateName": "IL",
    "PracticeLocationAddressPostalCode": "60201",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "847-570-2000",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "12/04/2012",
    "LastUpdateDate": "07/12/2018",
    "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": "363LA2100X",
        "TaxonomyName": "Acute Care Nurse Practitioner",
        "LicenseNumber": "209.009985",
        "LicenseNumberStateCode": "IL",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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