{
"Npi": {
"NPI": "1588861827",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "ST.ARNOLD",
"FirstName": "JENNIFER",
"MiddleName": "ANN",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "RN",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "THEIS",
"OtherFirstName": "JENNIFER",
"OtherMiddleName": "ANN",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "5953 E MABEL NELSON RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SOUTH RANGE",
"MailingAddressStateName": "WI",
"MailingAddressPostalCode": "54874-8171",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "715-392-9199",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "2900 PIEDMONT AVE",
"SecondLinePracticeLocationAddress": "SUPERIOR HEALTH CENTER",
"PracticeLocationAddressCityName": "DULUTH",
"PracticeLocationAddressStateName": "MN",
"PracticeLocationAddressPostalCode": "55811",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "218-727-8228",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "06/29/2007",
"LastUpdateDate": "09/11/2025",
"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": "163W00000X",
"TaxonomyName": "Registered Nurse",
"LicenseNumber": "R 174692-3",
"LicenseNumberStateCode": "MN",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "164W00000X",
"TaxonomyName": "Licensed Practical Nurse",
"LicenseNumber": "R 174692-3",
"LicenseNumberStateCode": "MN",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "163W00000X",
"TaxonomyName": "Registered Nurse",
"LicenseNumber": null,
"LicenseNumberStateCode": "WI",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}