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1144399759 NPI number — SUSAN E. PERSONS MS, LP

NPI Number: 1144399759
Health Care Provider/Practitioner: SUSAN E. PERSONS MS, LP

Information about “1144399759” NPI (SUSAN E. PERSONS MS, LP) exists in 1144399759 in HTML format HTML  |  1144399759 in plain Text format TXT  |  1144399759 in PDF (Portable Document Format) PDF  |  1144399759 in an XML format XML  formats.

NPI Number : 1144399759 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1144399759",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "PERSONS",
    "FirstName": "SUSAN",
    "MiddleName": "E.",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "MS, LP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1609 RIVER DR S",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "WABASHA",
    "MailingAddressStateName": "MN",
    "MailingAddressPostalCode": "55981-1768",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "651-565-0126",
    "MailingAddressFaxNumber": "651-565-0126",
    "FirstLinePracticeLocationAddress": "1000 LAKESHORE DR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "MOOSE LAKE",
    "PracticeLocationAddressStateName": "MN",
    "PracticeLocationAddressPostalCode": "55767-9449",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "218-485-5419",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "11/07/2006",
    "LastUpdateDate": "07/23/2011",
    "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": "103T00000X",
          "TaxonomyName": "Psychologist",
          "LicenseNumber": "LP3599",
          "LicenseNumberStateCode": "MN",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "103TP2701X",
          "TaxonomyName": "Group Psychotherapy Psychologist",
          "LicenseNumber": "LP3599",
          "LicenseNumberStateCode": "MN",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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