NPI Code Detail JSON Logo

1619264942 NPI number — JENNIFER ANN FRAIK FNP-C

NPI Number: 1619264942
Health Care Provider/Practitioner: JENNIFER ANN FRAIK FNP-C

Information about “1619264942” NPI (JENNIFER ANN FRAIK FNP-C) exists in 1619264942 in HTML format HTML  |  1619264942 in plain Text format TXT  |  1619264942 in PDF (Portable Document Format) PDF  |  1619264942 in an XML format XML  formats.

NPI Number : 1619264942 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1619264942",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "FRAIK",
    "FirstName": "JENNIFER",
    "MiddleName": "ANN",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "FNP-C",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "CARLSON",
    "OtherFirstName": "JENNIFER",
    "OtherMiddleName": "ANN",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "2324 FROHN RD NE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BEMIDJI",
    "MailingAddressStateName": "MN",
    "MailingAddressPostalCode": "56601-7405",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "218-556-3009",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1500 BIRCHMONT DR NE # 42",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "BEMIDJI",
    "PracticeLocationAddressStateName": "MN",
    "PracticeLocationAddressPostalCode": "56601-2699",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "218-755-2871",
    "PracticeLocationAddressFaxNumber": "218-755-2750",
    "EnumerationDate": "07/07/2011",
    "LastUpdateDate": "05/19/2025",
    "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": "363LF0000X",
        "TaxonomyName": "Family Nurse Practitioner",
        "LicenseNumber": "R1649965",
        "LicenseNumberStateCode": "MN",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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