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1700710274 NPI number — KELSEY GREEN RN

NPI Number: 1700710274
Health Care Provider/Practitioner: KELSEY GREEN RN

Information about “1700710274” NPI (KELSEY GREEN RN) exists in 1700710274 in HTML format HTML  |  1700710274 in plain Text format TXT  |  1700710274 in PDF (Portable Document Format) PDF  |  1700710274 in an XML format XML  formats.

NPI Number : 1700710274 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1700710274",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "GREEN",
    "FirstName": "KELSEY",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "RN",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "WILLIAMS",
    "OtherFirstName": "KELSEY",
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "RN",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "1120 178TH ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "HAMMOND",
    "MailingAddressStateName": "WI",
    "MailingAddressPostalCode": "54015-5418",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "852 E DIVISION ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "RIVER FALLS",
    "PracticeLocationAddressStateName": "WI",
    "PracticeLocationAddressPostalCode": "54022-2599",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "715-425-1800",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "06/10/2026",
    "LastUpdateDate": "06/10/2026",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "X",
    "Gender": null,
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "163WS0200X",
        "TaxonomyName": "School Registered Nurse",
        "LicenseNumber": "190013",
        "LicenseNumberStateCode": "WI",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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