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1629595798 NPI number — PAIGE LYNN PRATHER LPN, LMT

NPI Number: 1629595798
Health Care Provider/Practitioner: PAIGE LYNN PRATHER LPN, LMT

Information about “1629595798” NPI (PAIGE LYNN PRATHER LPN, LMT) exists in 1629595798 in HTML format HTML  |  1629595798 in plain Text format TXT  |  1629595798 in PDF (Portable Document Format) PDF  |  1629595798 in an XML format XML  formats.

NPI Number : 1629595798 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1629595798",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "PRATHER",
    "FirstName": "PAIGE",
    "MiddleName": "LYNN",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "LPN, LMT",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "RINEHART",
    "OtherFirstName": "PAIGE",
    "OtherMiddleName": "LYNN",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "5225 7TH ST W",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "LEHIGH ACRES",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "33971-1034",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "239-321-2989",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "5225 7TH ST W",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LEHIGH ACRES",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "33971-1034",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "239-321-2989",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "08/29/2017",
    "LastUpdateDate": "07/20/2021",
    "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": "172M00000X",
          "TaxonomyName": "Mechanotherapist",
          "LicenseNumber": "MA82606",
          "LicenseNumberStateCode": "FL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "225700000X",
          "TaxonomyName": "Massage Therapist",
          "LicenseNumber": "MA82606",
          "LicenseNumberStateCode": "FL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "164W00000X",
          "TaxonomyName": "Licensed Practical Nurse",
          "LicenseNumber": "PN5249933",
          "LicenseNumberStateCode": "FL",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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