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1245406453 NPI number — LIZA MARIE O HEIMANN NP

NPI Number: 1245406453
Health Care Provider/Practitioner: LIZA MARIE O HEIMANN NP

Information about “1245406453” NPI (LIZA MARIE O HEIMANN NP) exists in 1245406453 in HTML format HTML  |  1245406453 in plain Text format TXT  |  1245406453 in PDF (Portable Document Format) PDF  |  1245406453 in an XML format XML  formats.

NPI Number : 1245406453 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1245406453",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "HEIMANN",
    "FirstName": "LIZA MARIE",
    "MiddleName": "O",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "NP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "ORTILLO",
    "OtherFirstName": "LIZA MARIE",
    "OtherMiddleName": "O",
    "OtherNamePrefix": "MISS",
    "OtherNameSuffix": null,
    "OtherCredential": "NP",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "1 BARNES JEWISH HOSPITAL PLZ",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SAINT LOUIS",
    "MailingAddressStateName": "MO",
    "MailingAddressPostalCode": "63110-1003",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "314-454-8134",
    "MailingAddressFaxNumber": "314-454-8180",
    "FirstLinePracticeLocationAddress": "1 BARNES JEWISH HOSPITAL PLZ",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SAINT LOUIS",
    "PracticeLocationAddressStateName": "MO",
    "PracticeLocationAddressPostalCode": "63110-1003",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "314-454-8134",
    "PracticeLocationAddressFaxNumber": "314-454-8180",
    "EnumerationDate": "05/07/2008",
    "LastUpdateDate": "12/31/2025",
    "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": "363LA2200X",
          "TaxonomyName": "Adult Health Nurse Practitioner",
          "LicenseNumber": "2002008550",
          "LicenseNumberStateCode": "MO",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LF0000X",
          "TaxonomyName": "Family Nurse Practitioner",
          "LicenseNumber": "2002008550",
          "LicenseNumberStateCode": "MO",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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