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1457499113 NPI number — KATHLEEN ANNE ERWIN MD

NPI Number: 1457499113
Health Care Provider/Practitioner: KATHLEEN ANNE ERWIN MD

Information about “1457499113” NPI (KATHLEEN ANNE ERWIN MD) exists in 1457499113 in HTML format HTML  |  1457499113 in plain Text format TXT  |  1457499113 in PDF (Portable Document Format) PDF  |  1457499113 in an XML format XML  formats.

NPI Number : 1457499113 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1457499113",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "ERWIN",
    "FirstName": "KATHLEEN",
    "MiddleName": "ANNE",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "HUBBARD",
    "OtherFirstName": "KATHLEEN",
    "OtherMiddleName": "ANNE",
    "OtherNamePrefix": "DR.",
    "OtherNameSuffix": null,
    "OtherCredential": "M.D.",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "190 E BANNOCK ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BOISE",
    "MailingAddressStateName": "ID",
    "MailingAddressPostalCode": "83712-6241",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": "208-239-3665",
    "FirstLinePracticeLocationAddress": "228 SHOUP AVE W",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "TWIN FALLS",
    "PracticeLocationAddressStateName": "ID",
    "PracticeLocationAddressPostalCode": "83301-5022",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "208-814-7900",
    "PracticeLocationAddressFaxNumber": "208-814-7940",
    "EnumerationDate": "02/02/2007",
    "LastUpdateDate": "03/13/2025",
    "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": "2084P0800X",
          "TaxonomyName": "Psychiatry Physician",
          "LicenseNumber": "A95835",
          "LicenseNumberStateCode": "CA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "2084P0800X",
          "TaxonomyName": "Psychiatry Physician",
          "LicenseNumber": "M-13099",
          "LicenseNumberStateCode": "ID",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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