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1538145289 NPI number — LARA ABRAHAMSON MD

NPI Number: 1538145289
Health Care Provider/Practitioner: LARA ABRAHAMSON MD

Information about “1538145289” NPI (LARA ABRAHAMSON MD) exists in 1538145289 in HTML format HTML  |  1538145289 in plain Text format TXT  |  1538145289 in PDF (Portable Document Format) PDF  |  1538145289 in an XML format XML  formats.

NPI Number : 1538145289 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1538145289",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "ABRAHAMSON",
    "FirstName": "LARA",
    "MiddleName": null,
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "3702 AUTOMATION WAY",
    "SecondLineMailingAddress": "SUITE 103",
    "MailingAddressCityName": "FORT COLLINS",
    "MailingAddressStateName": "CO",
    "MailingAddressPostalCode": "80525-5737",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "970-224-1670",
    "MailingAddressFaxNumber": "970-495-6218",
    "FirstLinePracticeLocationAddress": "1113 OAKRIDGE DR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "FORT COLLINS",
    "PracticeLocationAddressStateName": "CO",
    "PracticeLocationAddressPostalCode": "80525-5591",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "970-225-0040",
    "PracticeLocationAddressFaxNumber": "970-221-5206",
    "EnumerationDate": "12/15/2005",
    "LastUpdateDate": "09/19/2014",
    "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": "207Q00000X",
        "TaxonomyName": "Family Medicine Physician",
        "LicenseNumber": "41086",
        "LicenseNumberStateCode": "CO",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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