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1396369856 NPI number — MELISSA GUTWEIN NP

NPI Number: 1396369856
Health Care Provider/Practitioner: MELISSA GUTWEIN NP

Information about “1396369856” NPI (MELISSA GUTWEIN NP) exists in 1396369856 in HTML format HTML  |  1396369856 in plain Text format TXT  |  1396369856 in PDF (Portable Document Format) PDF  |  1396369856 in an XML format XML  formats.

NPI Number : 1396369856 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1396369856",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "GUTWEIN",
    "FirstName": "MELISSA",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "NP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "DULIN",
    "OtherFirstName": "MELISSA",
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "1200 W WHITE RIVER BLVD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "MUNCIE",
    "MailingAddressStateName": "IN",
    "MailingAddressPostalCode": "47303-4988",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "765-747-4492",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "810 S 6TH ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "MONTICELLO",
    "PracticeLocationAddressStateName": "IN",
    "PracticeLocationAddressPostalCode": "47960-8201",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "574-583-6543",
    "PracticeLocationAddressFaxNumber": "574-583-9502",
    "EnumerationDate": "06/01/2020",
    "LastUpdateDate": "04/25/2023",
    "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": "28206966A",
          "LicenseNumberStateCode": "IN",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LF0000X",
          "TaxonomyName": "Family Nurse Practitioner",
          "LicenseNumber": "71010101A",
          "LicenseNumberStateCode": "IN",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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