1710259502 NPI number — LYNDSEY PAIGE ELZNER M.S. CCC/SLP

NPI Number: 1710259502
Health Care Provider/Practitioner: LYNDSEY PAIGE ELZNER M.S. CCC/SLP

NPI Number : 1710259502 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1710259502",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "ELZNER",
    "FirstName": "LYNDSEY",
    "MiddleName": "PAIGE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "M.S. CCC/SLP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "BEENE",
    "OtherFirstName": "LYNDSEY",
    "OtherMiddleName": "PAIGE",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "M.S. CCC/SLP",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "9925 GREENFIELD DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "DALLAS",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "75238-2601",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "214-543-6581",
    "MailingAddressFaxNumber": "214-559-0210",
    "FirstLinePracticeLocationAddress": "9925 GREENFIELD DR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "DALLAS",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "75238-2601",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "214-543-6581",
    "PracticeLocationAddressFaxNumber": "214-559-0210",
    "EnumerationDate": "02/08/2012",
    "LastUpdateDate": "02/08/2012",
    "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": "235Z00000X",
        "TaxonomyName": "Speech-Language Pathologist",
        "LicenseNumber": "105642",
        "LicenseNumberStateCode": "TX",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}