NPI Code Detail JSON Logo

1215386396 NPI number — KRYSTAL KNIGHT NP

NPI Number: 1215386396
Health Care Provider/Practitioner: KRYSTAL KNIGHT NP

Information about “1215386396” NPI (KRYSTAL KNIGHT NP) exists in 1215386396 in HTML format HTML  |  1215386396 in plain Text format TXT  |  1215386396 in PDF (Portable Document Format) PDF  |  1215386396 in an XML format XML  formats.

NPI Number : 1215386396 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1215386396",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "KNIGHT",
    "FirstName": "KRYSTAL",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "NP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "631 PROFESSIONAL DR STE 120",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "LAWRENCEVILLE",
    "MailingAddressStateName": "GA",
    "MailingAddressPostalCode": "30046-3370",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "678-312-3290",
    "MailingAddressFaxNumber": "678-312-2733",
    "FirstLinePracticeLocationAddress": "1000 MEDICAL CENTER BLVD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LAWRENCEVILLE",
    "PracticeLocationAddressStateName": "GA",
    "PracticeLocationAddressPostalCode": "30046-7694",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "678-312-2418",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "06/08/2016",
    "LastUpdateDate": "10/29/2020",
    "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": "163W00000X",
          "TaxonomyName": "Registered Nurse",
          "LicenseNumber": "RN165295",
          "LicenseNumberStateCode": "GA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LA2100X",
          "TaxonomyName": "Acute Care Nurse Practitioner",
          "LicenseNumber": "RN165295",
          "LicenseNumberStateCode": "GA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LC0200X",
          "TaxonomyName": "Critical Care Medicine Nurse Practitioner",
          "LicenseNumber": "RN165295",
          "LicenseNumberStateCode": "GA",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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