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1720223357 NPI number — TERESA LYNN MASE H.I.S.

NPI Number: 1720223357
Health Care Provider/Practitioner: TERESA LYNN MASE H.I.S.

Information about “1720223357” NPI (TERESA LYNN MASE H.I.S.) exists in 1720223357 in HTML format HTML  |  1720223357 in plain Text format TXT  |  1720223357 in PDF (Portable Document Format) PDF  |  1720223357 in an XML format XML  formats.

NPI Number : 1720223357 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1720223357",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MASE",
    "FirstName": "TERESA",
    "MiddleName": "LYNN",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "H.I.S.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1171 S MAIN ST STE 4",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CHELSEA",
    "MailingAddressStateName": "MI",
    "MailingAddressPostalCode": "48118-1621",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "734-627-7294",
    "MailingAddressFaxNumber": "734-433-9211",
    "FirstLinePracticeLocationAddress": "1171 S MAIN ST STE 4",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "CHELSEA",
    "PracticeLocationAddressStateName": "MI",
    "PracticeLocationAddressPostalCode": "48118-1621",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "734-627-7294",
    "PracticeLocationAddressFaxNumber": "734-433-9211",
    "EnumerationDate": "12/11/2008",
    "LastUpdateDate": "03/18/2024",
    "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": "237700000X",
          "TaxonomyName": "Hearing Instrument Specialist",
          "LicenseNumber": "17001212A",
          "LicenseNumberStateCode": "IN",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "237700000X",
          "TaxonomyName": "Hearing Instrument Specialist",
          "LicenseNumber": "3502013266",
          "LicenseNumberStateCode": "MI",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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