1447627419 NPI number — CONSTANCE ANN RICHTER H.P.-C.M.T. - Q.T.P.

NPI Number: 1447627419
Health Care Provider/Practitioner: CONSTANCE ANN RICHTER H.P.-C.M.T. - Q.T.P.

NPI Number : 1447627419 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1447627419",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "RICHTER",
    "FirstName": "CONSTANCE",
    "MiddleName": "ANN",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "H.P.-C.M.T. - Q.T.P.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "PO BOX 136",
    "SecondLineMailingAddress": "422 EAST MAIN ST.",
    "MailingAddressCityName": "TRIMONT",
    "MailingAddressStateName": "MN",
    "MailingAddressPostalCode": "56176",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "507-639-6343",
    "MailingAddressFaxNumber": "507-639-6343",
    "FirstLinePracticeLocationAddress": "422 EAST MAIN ST.",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "TRIMONT",
    "PracticeLocationAddressStateName": "MN",
    "PracticeLocationAddressPostalCode": "56176",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "507-639-6343",
    "PracticeLocationAddressFaxNumber": "507-639-6343",
    "EnumerationDate": "08/26/2015",
    "LastUpdateDate": "08/26/2015",
    "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": "225700000X",
        "TaxonomyName": "Massage Therapist",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}