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1164268538 NPI number — MEGAN M PETERSON LPN

NPI Number: 1164268538
Health Care Provider/Practitioner: MEGAN M PETERSON LPN

Information about “1164268538” NPI (MEGAN M PETERSON LPN) exists in 1164268538 in HTML format HTML  |  1164268538 in plain Text format TXT  |  1164268538 in PDF (Portable Document Format) PDF  |  1164268538 in an XML format XML  formats.

NPI Number : 1164268538 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1164268538",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "PETERSON",
    "FirstName": "MEGAN",
    "MiddleName": "M",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "LPN",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "130 S MAIN ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CASTILE",
    "MailingAddressStateName": "NY",
    "MailingAddressPostalCode": "14427-9720",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "585-356-6388",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "15 PUTNAM PL",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "ATTICA",
    "PracticeLocationAddressStateName": "NY",
    "PracticeLocationAddressPostalCode": "14011-1115",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "585-356-4098",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "07/05/2024",
    "LastUpdateDate": "07/05/2024",
    "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": "3439001",
        "LicenseNumberStateCode": "NY",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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