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1639312333 NPI number — LISA E DISHMAN RRT, RCP

NPI Number: 1639312333
Health Care Provider/Practitioner: LISA E DISHMAN RRT, RCP

Information about “1639312333” NPI (LISA E DISHMAN RRT, RCP) exists in 1639312333 in HTML format HTML  |  1639312333 in plain Text format TXT  |  1639312333 in PDF (Portable Document Format) PDF  |  1639312333 in an XML format XML  formats.

NPI Number : 1639312333 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1639312333",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "DISHMAN",
    "FirstName": "LISA",
    "MiddleName": "E",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "RRT, RCP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "SUPTELA",
    "OtherFirstName": "LISA",
    "OtherMiddleName": "E.",
    "OtherNamePrefix": "MISS",
    "OtherNameSuffix": null,
    "OtherCredential": "RRT, RCP",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "700-B CROMWELL DRIVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "GREENVILLE",
    "MailingAddressStateName": "NC",
    "MailingAddressPostalCode": "27858-5832",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "252-830-2094",
    "MailingAddressFaxNumber": "252-355-7358",
    "FirstLinePracticeLocationAddress": "700-B CROMWELL DRIVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "GREENVILLE",
    "PracticeLocationAddressStateName": "NC",
    "PracticeLocationAddressPostalCode": "27858-5832",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "252-830-2094",
    "PracticeLocationAddressFaxNumber": "252-355-7358",
    "EnumerationDate": "04/09/2009",
    "LastUpdateDate": "03/12/2012",
    "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": "227900000X",
          "TaxonomyName": "Registered Respiratory Therapist",
          "LicenseNumber": "4731",
          "LicenseNumberStateCode": "NC",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "227900000X",
          "TaxonomyName": "Registered Respiratory Therapist",
          "LicenseNumber": "A-4731",
          "LicenseNumberStateCode": "NC",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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