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1396847075 NPI number — SUSAN LEA THIEVON M.S., APRN

NPI Number: 1396847075
Health Care Provider/Practitioner: SUSAN LEA THIEVON M.S., APRN

Information about “1396847075” NPI (SUSAN LEA THIEVON M.S., APRN) exists in 1396847075 in HTML format HTML  |  1396847075 in plain Text format TXT  |  1396847075 in PDF (Portable Document Format) PDF  |  1396847075 in an XML format XML  formats.

NPI Number : 1396847075 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1396847075",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "THIEVON",
    "FirstName": "SUSAN",
    "MiddleName": "LEA",
    "NamePrefix": "MS.",
    "NameSuffix": null,
    "Credential": "M.S., APRN",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "CATES",
    "OtherFirstName": "SUSAN",
    "OtherMiddleName": "LEA",
    "OtherNamePrefix": "MS.",
    "OtherNameSuffix": null,
    "OtherCredential": "M.S. ARNP",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "1422 ROUTE 66",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "RANDOLPH",
    "MailingAddressStateName": "VT",
    "MailingAddressPostalCode": "05060-7718",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "802-728-7100",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1422 ROUTE 66",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "RANDOLPH",
    "PracticeLocationAddressStateName": "VT",
    "PracticeLocationAddressPostalCode": "05060-7718",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "802-728-7100",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "09/02/2006",
    "LastUpdateDate": "01/07/2025",
    "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": "363LF0000X",
          "TaxonomyName": "Family Nurse Practitioner",
          "LicenseNumber": "049495-23",
          "LicenseNumberStateCode": "NH",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LP2300X",
          "TaxonomyName": "Primary Care Nurse Practitioner",
          "LicenseNumber": "0494952303",
          "LicenseNumberStateCode": "NH",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LF0000X",
          "TaxonomyName": "Family Nurse Practitioner",
          "LicenseNumber": "101.0134836",
          "LicenseNumberStateCode": "VT",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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