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1659502789 NPI number — ESTHER OFORIWA KINSELLA PA-C

NPI Number: 1659502789
Health Care Provider/Practitioner: ESTHER OFORIWA KINSELLA PA-C

Information about “1659502789” NPI (ESTHER OFORIWA KINSELLA PA-C) exists in 1659502789 in HTML format HTML  |  1659502789 in plain Text format TXT  |  1659502789 in PDF (Portable Document Format) PDF  |  1659502789 in an XML format XML  formats.

NPI Number : 1659502789 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1659502789",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "KINSELLA",
    "FirstName": "ESTHER",
    "MiddleName": "OFORIWA",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "PA-C",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "OKOAMPA",
    "OtherFirstName": "ESTHER",
    "OtherMiddleName": "OFORIWA",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "PA-C",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "2960 123RD CIR NE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BLAINE",
    "MailingAddressStateName": "MN",
    "MailingAddressPostalCode": "55449-5878",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "763-300-0614",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "640 JACKSON ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SAINT PAUL",
    "PracticeLocationAddressStateName": "MN",
    "PracticeLocationAddressPostalCode": "55101-2502",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "651-254-3799",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "08/06/2009",
    "LastUpdateDate": "09/18/2009",
    "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": "363A00000X",
          "TaxonomyName": "Physician Assistant",
          "LicenseNumber": "10592",
          "LicenseNumberStateCode": "MN",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "363AM0700X",
          "TaxonomyName": "Medical Physician Assistant",
          "LicenseNumber": "10592",
          "LicenseNumberStateCode": "MN",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363AS0400X",
          "TaxonomyName": "Surgical Physician Assistant",
          "LicenseNumber": "10592",
          "LicenseNumberStateCode": "MN",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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