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1396206678 NPI number — LISA M WATSON ARNP

NPI Number: 1396206678
Health Care Provider/Practitioner: LISA M WATSON ARNP

Information about “1396206678” NPI (LISA M WATSON ARNP) exists in 1396206678 in HTML format HTML  |  1396206678 in plain Text format TXT  |  1396206678 in PDF (Portable Document Format) PDF  |  1396206678 in an XML format XML  formats.

NPI Number : 1396206678 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1396206678",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "WATSON",
    "FirstName": "LISA",
    "MiddleName": "M",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "ARNP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "WATSON",
    "OtherFirstName": "LISA",
    "OtherMiddleName": "M",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "LISA HARRISON",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "3001 WILDFLOWER DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "LA PLATA",
    "MailingAddressStateName": "MD",
    "MailingAddressPostalCode": "20646-3271",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "321-431-2027",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "130 HOSPITAL RD STE 102",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "PRINCE FREDERICK",
    "PracticeLocationAddressStateName": "MD",
    "PracticeLocationAddressPostalCode": "20678-4029",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "321-431-2027",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "03/28/2019",
    "LastUpdateDate": "03/28/2025",
    "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": "363LA2100X",
          "TaxonomyName": "Acute Care Nurse Practitioner",
          "LicenseNumber": "RN296596",
          "LicenseNumberStateCode": "GA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LA2100X",
          "TaxonomyName": "Acute Care Nurse Practitioner",
          "LicenseNumber": "AC002671",
          "LicenseNumberStateCode": "MD",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LA2100X",
          "TaxonomyName": "Acute Care Nurse Practitioner",
          "LicenseNumber": "APRN11001327",
          "LicenseNumberStateCode": "FL",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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