1619413671 NPI number — CHRISTIE LYNNE LODICS DNP, MSN, APRN, FNP

NPI Number: 1619413671
Health Care Provider/Practitioner: CHRISTIE LYNNE LODICS DNP, MSN, APRN, FNP

NPI Number : 1619413671 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1619413671",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "LODICS",
    "FirstName": "CHRISTIE",
    "MiddleName": "LYNNE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "DNP, MSN, APRN, FNP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "MEDELLIN",
    "OtherFirstName": "CHRISTIE",
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "9016 DEWBERRY CT",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "INDIANAPOLIS",
    "MailingAddressStateName": "IN",
    "MailingAddressPostalCode": "46260-1527",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "317-522-8081",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1481 W 10TH ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "INDIANAPOLIS",
    "PracticeLocationAddressStateName": "IN",
    "PracticeLocationAddressPostalCode": "46202-2803",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "317-522-8081",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "01/16/2017",
    "LastUpdateDate": "06/21/2023",
    "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": "71006883A",
          "LicenseNumberStateCode": "IN",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LF0000X",
          "TaxonomyName": "Family Nurse Practitioner",
          "LicenseNumber": "28213376A",
          "LicenseNumberStateCode": "IN",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}