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1649876574 NPI number — ELIZABETH PEARL BORER OTR/L

NPI Number: 1649876574
Health Care Provider/Practitioner: ELIZABETH PEARL BORER OTR/L

Information about “1649876574” NPI (ELIZABETH PEARL BORER OTR/L) exists in 1649876574 in HTML format HTML  |  1649876574 in plain Text format TXT  |  1649876574 in PDF (Portable Document Format) PDF  |  1649876574 in an XML format XML  formats.

NPI Number : 1649876574 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1649876574",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BORER",
    "FirstName": "ELIZABETH",
    "MiddleName": "PEARL",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "OTR/L",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "LABADIE",
    "OtherFirstName": "ELIZABETH",
    "OtherMiddleName": "PEARL",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "OTR/L",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "PO BOX 5285",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "GRAND ISLAND",
    "MailingAddressStateName": "NE",
    "MailingAddressPostalCode": "68802-5285",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "308-675-1853",
    "MailingAddressFaxNumber": "308-210-4121",
    "FirstLinePracticeLocationAddress": "2707 2ND AVE STE B",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "KEARNEY",
    "PracticeLocationAddressStateName": "NE",
    "PracticeLocationAddressPostalCode": "68847-4401",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "308-234-1278",
    "PracticeLocationAddressFaxNumber": "308-234-1279",
    "EnumerationDate": "12/07/2020",
    "LastUpdateDate": "11/29/2024",
    "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": "225X00000X",
          "TaxonomyName": "Occupational Therapist",
          "LicenseNumber": "2481",
          "LicenseNumberStateCode": "NE",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "225X00000X",
          "TaxonomyName": "Occupational Therapist",
          "LicenseNumber": "106588",
          "LicenseNumberStateCode": "IA",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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