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1689880411 NPI number — MARY KATHERINE TEISINGER NICHOLSON A.P., D.O.M.

NPI Number: 1689880411
Health Care Provider/Practitioner: MARY KATHERINE TEISINGER NICHOLSON A.P., D.O.M.

Information about “1689880411” NPI (MARY KATHERINE TEISINGER NICHOLSON A.P., D.O.M.) exists in 1689880411 in HTML format HTML  |  1689880411 in plain Text format TXT  |  1689880411 in PDF (Portable Document Format) PDF  |  1689880411 in an XML format XML  formats.

NPI Number : 1689880411 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1689880411",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "NICHOLSON",
    "FirstName": "MARY KATHERINE",
    "MiddleName": "TEISINGER",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "A.P., D.O.M.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "TEISINGER",
    "OtherFirstName": "KATHERINE",
    "OtherMiddleName": null,
    "OtherNamePrefix": "DR.",
    "OtherNameSuffix": null,
    "OtherCredential": "A.P., D.O.M.",
    "OtherLastNameTypeCode": "2",
    "FirstLineMailingAddress": "535 E PIERCE ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "LAKE ALFRED",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "33850-3027",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "863-956-5604",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "526 AVENUE I NW",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "WINTER HAVEN",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "33881-4045",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "863-521-2999",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "05/16/2007",
    "LastUpdateDate": "07/08/2007",
    "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": "171100000X",
        "TaxonomyName": "Acupuncturist",
        "LicenseNumber": "AP 1339",
        "LicenseNumberStateCode": "FL",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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