1679712087 NPI number — JULIANN PAIGE MATHENY FNP-C, CPNP-AC

NPI Number: 1679712087
Health Care Provider/Practitioner: JULIANN PAIGE MATHENY FNP-C, CPNP-AC

NPI Number : 1679712087 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1679712087",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MATHENY",
    "FirstName": "JULIANN",
    "MiddleName": "PAIGE",
    "NamePrefix": "MS.",
    "NameSuffix": null,
    "Credential": "FNP-C, CPNP-AC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "STURM",
    "OtherFirstName": "JULIANN",
    "OtherMiddleName": "PAIGE",
    "OtherNamePrefix": "MRS.",
    "OtherNameSuffix": null,
    "OtherCredential": "RN, APRN",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "138 LEADER AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "LEXINGTON",
    "MailingAddressStateName": "KY",
    "MailingAddressPostalCode": "40506-9983",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "502-693-0551",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "138 LEADER AVE SUITE 119",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LEXINGTON",
    "PracticeLocationAddressStateName": "KY",
    "PracticeLocationAddressPostalCode": "40506-3446",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "859-323-7305",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "02/09/2009",
    "LastUpdateDate": "09/01/2020",
    "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": "363LF0000X",
          "TaxonomyName": "Family Nurse Practitioner",
          "LicenseNumber": "3011424",
          "LicenseNumberStateCode": "KY",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LA2100X",
          "TaxonomyName": "Acute Care Nurse Practitioner",
          "LicenseNumber": "3011424",
          "LicenseNumberStateCode": "KY",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}