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1629534813 NPI number — HEATHER NICOLE THOMAS APNP

NPI Number: 1629534813
Health Care Provider/Practitioner: HEATHER NICOLE THOMAS APNP

Information about “1629534813” NPI (HEATHER NICOLE THOMAS APNP) exists in 1629534813 in HTML format HTML  |  1629534813 in plain Text format TXT  |  1629534813 in PDF (Portable Document Format) PDF  |  1629534813 in an XML format XML  formats.

NPI Number : 1629534813 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1629534813",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "THOMAS",
    "FirstName": "HEATHER",
    "MiddleName": "NICOLE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "APNP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "GROHS",
    "OtherFirstName": "HEATHER",
    "OtherMiddleName": "NICOLE",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "3209 TANGLEWOOD DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "WAUKESHA",
    "MailingAddressStateName": "WI",
    "MailingAddressPostalCode": "53189-6889",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "262-385-2004",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "496 MC CANNA PKWY",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "BURLINGTON",
    "PracticeLocationAddressStateName": "WI",
    "PracticeLocationAddressPostalCode": "53105-3623",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "414-279-6128",
    "PracticeLocationAddressFaxNumber": "866-538-6903",
    "EnumerationDate": "02/13/2019",
    "LastUpdateDate": "01/13/2026",
    "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": "9097-33",
          "LicenseNumberStateCode": "WI",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "163W00000X",
          "TaxonomyName": "Registered Nurse",
          "LicenseNumber": "171048-30",
          "LicenseNumberStateCode": "WI",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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