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1225827793 NPI number — LAURA BO-KHIA NIBOH WHNP-BC

NPI Number: 1225827793
Health Care Provider/Practitioner: LAURA BO-KHIA NIBOH WHNP-BC

Information about “1225827793” NPI (LAURA BO-KHIA NIBOH WHNP-BC) exists in 1225827793 in HTML format HTML  |  1225827793 in plain Text format TXT  |  1225827793 in PDF (Portable Document Format) PDF  |  1225827793 in an XML format XML  formats.

NPI Number : 1225827793 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1225827793",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "NIBOH",
    "FirstName": "LAURA",
    "MiddleName": "BO-KHIA",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "WHNP-BC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "PO BOX 959354 #280",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SAINT LOUIS",
    "MailingAddressStateName": "MO",
    "MailingAddressPostalCode": "63195-0001",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "314-286-2620",
    "MailingAddressFaxNumber": "314-286-2621",
    "FirstLinePracticeLocationAddress": "1110 HIGHLANDS PLAZA DRIVE",
    "SecondLinePracticeLocationAddress": "#280",
    "PracticeLocationAddressCityName": "SAINT LOUIS",
    "PracticeLocationAddressStateName": "MO",
    "PracticeLocationAddressPostalCode": "63110-1351",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "314-286-2620",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "05/01/2025",
    "LastUpdateDate": "09/17/2025",
    "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": "363LW0102X",
          "TaxonomyName": "Women's Health Nurse Practitioner",
          "LicenseNumber": "2016017714",
          "LicenseNumberStateCode": "MO",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363L00000X",
          "TaxonomyName": "Nurse Practitioner",
          "LicenseNumber": "2025016859",
          "LicenseNumberStateCode": "MO",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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