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1255030516 NPI number — ERIN PAIGE GREENLEE PMHNP

NPI Number: 1255030516
Health Care Provider/Practitioner: ERIN PAIGE GREENLEE PMHNP

Information about “1255030516” NPI (ERIN PAIGE GREENLEE PMHNP) exists in 1255030516 in HTML format HTML  |  1255030516 in plain Text format TXT  |  1255030516 in PDF (Portable Document Format) PDF  |  1255030516 in an XML format XML  formats.

NPI Number : 1255030516 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1255030516",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "GREENLEE",
    "FirstName": "ERIN",
    "MiddleName": "PAIGE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "PMHNP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "ROSS",
    "OtherFirstName": "ERIN",
    "OtherMiddleName": "PAIGE",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "RN",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "5300 STEWART RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "LEXINGTON",
    "MailingAddressStateName": "KY",
    "MailingAddressPostalCode": "40516-9519",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "740-505-4242",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "503 DARBY CREEK RD UNIT C",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LEXINGTON",
    "PracticeLocationAddressStateName": "KY",
    "PracticeLocationAddressPostalCode": "40509-1603",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "859-368-2567",
    "PracticeLocationAddressFaxNumber": "859-788-3905",
    "EnumerationDate": "02/27/2023",
    "LastUpdateDate": "06/25/2024",
    "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": "163W00000X",
          "TaxonomyName": "Registered Nurse",
          "LicenseNumber": "1140495",
          "LicenseNumberStateCode": "KY",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LP0808X",
          "TaxonomyName": "Psychiatric/Mental Health Nurse Practitioner",
          "LicenseNumber": "4010911",
          "LicenseNumberStateCode": "KY",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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