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1225266919 NPI number — JOANN M PENNINGTON P.A.

NPI Number: 1225266919
Health Care Provider/Practitioner: JOANN M PENNINGTON P.A.

Information about “1225266919” NPI (JOANN M PENNINGTON P.A.) exists in 1225266919 in HTML format HTML  |  1225266919 in plain Text format TXT  |  1225266919 in PDF (Portable Document Format) PDF  |  1225266919 in an XML format XML  formats.

NPI Number : 1225266919 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1225266919",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "PENNINGTON",
    "FirstName": "JOANN",
    "MiddleName": "M",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "P.A.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "PAULI",
    "OtherFirstName": "JOANN",
    "OtherMiddleName": "M",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "P.A.",
    "OtherLastNameTypeCode": "5",
    "FirstLineMailingAddress": "3077 N MAYFAIR RD STE 305",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "WAUWATOSA",
    "MailingAddressStateName": "WI",
    "MailingAddressPostalCode": "53222-4305",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "414-384-6700",
    "MailingAddressFaxNumber": "414-727-1058",
    "FirstLinePracticeLocationAddress": "3111 W RAWSON AVE",
    "SecondLinePracticeLocationAddress": "SUITE 200",
    "PracticeLocationAddressCityName": "FRANKLIN",
    "PracticeLocationAddressStateName": "WI",
    "PracticeLocationAddressPostalCode": "53132-9417",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "414-384-6700",
    "PracticeLocationAddressFaxNumber": "414-761-1921",
    "EnumerationDate": "07/01/2009",
    "LastUpdateDate": "03/04/2020",
    "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": "363A00000X",
        "TaxonomyName": "Physician Assistant",
        "LicenseNumber": "2421023",
        "LicenseNumberStateCode": "WI",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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