NPI Code Detail JSON Logo

1609967207 NPI number — NOELLE ANNE WESTRUM MD

NPI Number: 1609967207
Health Care Provider/Practitioner: NOELLE ANNE WESTRUM MD

Information about “1609967207” NPI (NOELLE ANNE WESTRUM MD) exists in 1609967207 in HTML format HTML  |  1609967207 in plain Text format TXT  |  1609967207 in PDF (Portable Document Format) PDF  |  1609967207 in an XML format XML  formats.

NPI Number : 1609967207 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1609967207",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "WESTRUM",
    "FirstName": "NOELLE",
    "MiddleName": "ANNE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "NIELSEN",
    "OtherFirstName": "NOELLE",
    "OtherMiddleName": "ANNE",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "MD",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "1012 E 2ND ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "DULUTH",
    "MailingAddressStateName": "MN",
    "MailingAddressPostalCode": "55805-2200",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "218-249-7870",
    "MailingAddressFaxNumber": "218-249-7801",
    "FirstLinePracticeLocationAddress": "1012 E 2ND ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "DULUTH",
    "PracticeLocationAddressStateName": "MN",
    "PracticeLocationAddressPostalCode": "55805",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "218-249-7870",
    "PracticeLocationAddressFaxNumber": "218-249-7801",
    "EnumerationDate": "09/27/2006",
    "LastUpdateDate": "03/26/2019",
    "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": "TD979",
          "LicenseNumberStateCode": "ME",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "208000000X",
          "TaxonomyName": "Pediatrics Physician",
          "LicenseNumber": "M7208",
          "LicenseNumberStateCode": "ID",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "208000000X",
          "TaxonomyName": "Pediatrics Physician",
          "LicenseNumber": "51308",
          "LicenseNumberStateCode": "MN",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "208000000X",
          "TaxonomyName": "Pediatrics Physician",
          "LicenseNumber": "MD00042543",
          "LicenseNumberStateCode": "WA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "208000000X",
          "TaxonomyName": "Pediatrics Physician",
          "LicenseNumber": "18874",
          "LicenseNumberStateCode": "OR",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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