NPI Code Detail JSON Logo

1558152892 NPI number — MARISSA JEAN PERRY APNP

NPI Number: 1558152892
Health Care Provider/Practitioner: MARISSA JEAN PERRY APNP

Information about “1558152892” NPI (MARISSA JEAN PERRY APNP) exists in 1558152892 in HTML format HTML  |  1558152892 in plain Text format TXT  |  1558152892 in PDF (Portable Document Format) PDF  |  1558152892 in an XML format XML  formats.

NPI Number : 1558152892 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1558152892",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "PERRY",
    "FirstName": "MARISSA",
    "MiddleName": "JEAN",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "APNP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "SCHOEN",
    "OtherFirstName": "MARISSA",
    "OtherMiddleName": "JEAN",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "3415 CUSTER ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "MANITOWOC",
    "MailingAddressStateName": "WI",
    "MailingAddressPostalCode": "54220-4324",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "920-652-9310",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "3415 CUSTER ST STE D",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "MANITOWOC",
    "PracticeLocationAddressStateName": "WI",
    "PracticeLocationAddressPostalCode": "54220-4328",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "920-652-9310",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "05/15/2025",
    "LastUpdateDate": "09/02/2025",
    "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": "363L00000X",
          "TaxonomyName": "Nurse Practitioner",
          "LicenseNumber": "17186-33",
          "LicenseNumberStateCode": "WI",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "163W00000X",
          "TaxonomyName": "Registered Nurse",
          "LicenseNumber": "244683-30",
          "LicenseNumberStateCode": "WI",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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