1255030532 NPI number — TARA LIN PANCIOTTI FNP-C, FNP-BC

NPI Number: 1255030532
Health Care Provider/Practitioner: TARA LIN PANCIOTTI FNP-C, FNP-BC

NPI Number : 1255030532 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1255030532",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "PANCIOTTI",
    "FirstName": "TARA",
    "MiddleName": "LIN",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "FNP-C, FNP-BC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "14 ELMDALE ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SEEKONK",
    "MailingAddressStateName": "MA",
    "MailingAddressPostalCode": "02771-5118",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1180 HOPE ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "BRISTOL",
    "PracticeLocationAddressStateName": "RI",
    "PracticeLocationAddressPostalCode": "02809-1126",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "401-253-8900",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "02/27/2023",
    "LastUpdateDate": "10/22/2023",
    "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": "RN2361401",
          "LicenseNumberStateCode": "MA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "163W00000X",
          "TaxonomyName": "Registered Nurse",
          "LicenseNumber": "RN60216",
          "LicenseNumberStateCode": "RI",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LF0000X",
          "TaxonomyName": "Family Nurse Practitioner",
          "LicenseNumber": "APRN03724",
          "LicenseNumberStateCode": "RI",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}