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1659866044 NPI number — ELIZABETH E DOLAN PA

NPI Number: 1659866044
Health Care Provider/Practitioner: ELIZABETH E DOLAN PA

Information about “1659866044” NPI (ELIZABETH E DOLAN PA) exists in 1659866044 in HTML format HTML  |  1659866044 in plain Text format TXT  |  1659866044 in PDF (Portable Document Format) PDF  |  1659866044 in an XML format XML  formats.

NPI Number : 1659866044 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1659866044",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "DOLAN",
    "FirstName": "ELIZABETH",
    "MiddleName": "E",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "PA",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "EMMERICH",
    "OtherFirstName": "ELIZABETH",
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "7974 UW HEALTH CT",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "MIDDLETON",
    "MailingAddressStateName": "WI",
    "MailingAddressPostalCode": "53562-5531",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "608-829-5485",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "750 UNIVERSITY ROW",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "MADISON",
    "PracticeLocationAddressStateName": "WI",
    "PracticeLocationAddressPostalCode": "53705-1311",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "608-890-5090",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "06/27/2018",
    "LastUpdateDate": "08/04/2021",
    "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": "363AM0700X",
          "TaxonomyName": "Medical Physician Assistant",
          "LicenseNumber": "4394",
          "LicenseNumberStateCode": "WI",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363A00000X",
          "TaxonomyName": "Physician Assistant",
          "LicenseNumber": "4394",
          "LicenseNumberStateCode": "WI",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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