NPI Code Detail JSON Logo

1508160102 NPI number — CRISTYN NICOLE BRANSTETTER M.D.

NPI Number: 1508160102
Health Care Provider/Practitioner: CRISTYN NICOLE BRANSTETTER M.D.

Information about “1508160102” NPI (CRISTYN NICOLE BRANSTETTER M.D.) exists in 1508160102 in HTML format HTML  |  1508160102 in plain Text format TXT  |  1508160102 in PDF (Portable Document Format) PDF  |  1508160102 in an XML format XML  formats.

NPI Number : 1508160102 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1508160102",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BRANSTETTER",
    "FirstName": "CRISTYN",
    "MiddleName": "NICOLE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "M.D.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "CAMET",
    "OtherFirstName": "CRISTYN",
    "OtherMiddleName": "NICOLE",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "M.D.",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "1 CHILDRENS WAY # 653",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "LITTLE ROCK",
    "MailingAddressStateName": "AR",
    "MailingAddressPostalCode": "72202-3500",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "501-364-1100",
    "MailingAddressFaxNumber": "501-364-4082",
    "FirstLinePracticeLocationAddress": "2601 GENE GEORGE BLVD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SPRINGDALE",
    "PracticeLocationAddressStateName": "AR",
    "PracticeLocationAddressPostalCode": "72762",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "479-725-6801",
    "PracticeLocationAddressFaxNumber": "479-725-6577",
    "EnumerationDate": "12/22/2010",
    "LastUpdateDate": "09/12/2024",
    "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": "208000000X",
          "TaxonomyName": "Pediatrics Physician",
          "LicenseNumber": "BP10030749",
          "LicenseNumberStateCode": "TX",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "208000000X",
          "TaxonomyName": "Pediatrics Physician",
          "LicenseNumber": "E-11200",
          "LicenseNumberStateCode": "AR",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "2080P0207X",
          "TaxonomyName": "Pediatric Hematology & Oncology Physician",
          "LicenseNumber": "N8893",
          "LicenseNumberStateCode": "TX",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "2080P0207X",
          "TaxonomyName": "Pediatric Hematology & Oncology Physician",
          "LicenseNumber": "E-11200",
          "LicenseNumberStateCode": "AR",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2025 Data Labs Health. All rights reserved.