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1407674807 NPI number — SIMONE BRINAE LITES

NPI Number: 1407674807
Health Care Provider/Practitioner: SIMONE BRINAE LITES

Information about “1407674807” NPI (SIMONE BRINAE LITES) exists in 1407674807 in HTML format HTML  |  1407674807 in plain Text format TXT  |  1407674807 in PDF (Portable Document Format) PDF  |  1407674807 in an XML format XML  formats.

NPI Number : 1407674807 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1407674807",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "LITES",
    "FirstName": "SIMONE",
    "MiddleName": "BRINAE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "425 SOUTHCROFT RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SPRINGFIELD",
    "MailingAddressStateName": "PA",
    "MailingAddressPostalCode": "19064-1325",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "3800 RESERVOIR RD NW # M2210",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "WASHINGTON",
    "PracticeLocationAddressStateName": "DC",
    "PracticeLocationAddressPostalCode": "20007-2113",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "202-444-8541",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "10/03/2024",
    "LastUpdateDate": "05/18/2025",
    "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": "363LG0600X",
        "TaxonomyName": "Gerontology Nurse Practitioner",
        "LicenseNumber": "AG07240171",
        "LicenseNumberStateCode": "PA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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