NPI Code Detail JSON Logo

1417441999 NPI number — KARISSA J JUNIOR ARNP

NPI Number: 1417441999
Health Care Provider/Practitioner: KARISSA J JUNIOR ARNP

Information about “1417441999” NPI (KARISSA J JUNIOR ARNP) exists in 1417441999 in HTML format HTML  |  1417441999 in plain Text format TXT  |  1417441999 in PDF (Portable Document Format) PDF  |  1417441999 in an XML format XML  formats.

NPI Number : 1417441999 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1417441999",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "JUNIOR",
    "FirstName": "KARISSA",
    "MiddleName": "J",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "ARNP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "SHINDELAR",
    "OtherFirstName": "KARISSA",
    "OtherMiddleName": "J.",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "ARNP",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "53685 TIMBER CIR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "KELLEY",
    "MailingAddressStateName": "IA",
    "MailingAddressPostalCode": "50134-4500",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "563-580-8655",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "802 S CENTER ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "MARSHALLTOWN",
    "PracticeLocationAddressStateName": "IA",
    "PracticeLocationAddressPostalCode": "50158-3350",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "641-844-5200",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "06/19/2018",
    "LastUpdateDate": "11/11/2024",
    "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": "363L00000X",
        "TaxonomyName": "Nurse Practitioner",
        "LicenseNumber": "A133743",
        "LicenseNumberStateCode": "IA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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