NPI Code Detail JSON Logo

1205690690 NPI number — JESSICA ANN MALHOTRA FNP-C

NPI Number: 1205690690
Health Care Provider/Practitioner: JESSICA ANN MALHOTRA FNP-C

Information about “1205690690” NPI (JESSICA ANN MALHOTRA FNP-C) exists in 1205690690 in HTML format HTML  |  1205690690 in plain Text format TXT  |  1205690690 in PDF (Portable Document Format) PDF  |  1205690690 in an XML format XML  formats.

NPI Number : 1205690690 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1205690690",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MALHOTRA",
    "FirstName": "JESSICA",
    "MiddleName": "ANN",
    "NamePrefix": "MS.",
    "NameSuffix": null,
    "Credential": "FNP-C",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "2532 BEACHVIEW CT",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "TROY",
    "MailingAddressStateName": "MI",
    "MailingAddressPostalCode": "48098-4203",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "586-381-3070",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "17330 GREYDALE AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "DETROIT",
    "PracticeLocationAddressStateName": "MI",
    "PracticeLocationAddressPostalCode": "48219-3248",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "855-445-4554",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "02/07/2024",
    "LastUpdateDate": "02/07/2024",
    "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": "163WE0003X",
          "TaxonomyName": "Emergency Registered Nurse",
          "LicenseNumber": "4704217456",
          "LicenseNumberStateCode": "MI",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LF0000X",
          "TaxonomyName": "Family Nurse Practitioner",
          "LicenseNumber": "4704217456NSA230P5",
          "LicenseNumberStateCode": "MI",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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