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1275960072 NPI number — MRS. MELISSA CROMER

NPI Number: 1275960072
Health Care Provider/Practitioner: MRS. MELISSA CROMER

Information about “1275960072” NPI (MRS. MELISSA CROMER) exists in 1275960072 in HTML format HTML  |  1275960072 in plain Text format TXT  |  1275960072 in PDF (Portable Document Format) PDF  |  1275960072 in an XML format XML  formats.

NPI Number : 1275960072 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1275960072",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "CROMER",
    "FirstName": "MELISSA",
    "MiddleName": null,
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "4911 N 26TH ST",
    "SecondLineMailingAddress": "SUITE 100",
    "MailingAddressCityName": "LINCOLN",
    "MailingAddressStateName": "NE",
    "MailingAddressPostalCode": "68521-4739",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "402-477-3110",
    "MailingAddressFaxNumber": "402-477-4990",
    "FirstLinePracticeLocationAddress": "504 E ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "FAIRBURY",
    "PracticeLocationAddressStateName": "NE",
    "PracticeLocationAddressPostalCode": "68352-2360",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "402-729-2639",
    "PracticeLocationAddressFaxNumber": "402-729-2644",
    "EnumerationDate": "10/11/2013",
    "LastUpdateDate": "10/11/2013",
    "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": "225X00000X",
        "TaxonomyName": "Occupational Therapist",
        "LicenseNumber": "436",
        "LicenseNumberStateCode": "NE",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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