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1720637176 NPI number — KRISTIN CAROLYNN GUTHRIE PA-C

NPI Number: 1720637176
Health Care Provider/Practitioner: KRISTIN CAROLYNN GUTHRIE PA-C

Information about “1720637176” NPI (KRISTIN CAROLYNN GUTHRIE PA-C) exists in 1720637176 in HTML format HTML  |  1720637176 in plain Text format TXT  |  1720637176 in PDF (Portable Document Format) PDF  |  1720637176 in an XML format XML  formats.

NPI Number : 1720637176 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1720637176",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "GUTHRIE",
    "FirstName": "KRISTIN",
    "MiddleName": "CAROLYNN",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "PA-C",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "KENNY",
    "OtherFirstName": "KRISTIN",
    "OtherMiddleName": "CAROLYNN",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "PA-C",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "W150S7048 CORNELL CIR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "MUSKEGO",
    "MailingAddressStateName": "WI",
    "MailingAddressPostalCode": "53150-8987",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "440-371-7624",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "W150S7048 CORNELL CIR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "MUSKEGO",
    "PracticeLocationAddressStateName": "WI",
    "PracticeLocationAddressPostalCode": "53150-8987",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "440-371-7624",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "09/09/2019",
    "LastUpdateDate": "02/19/2024",
    "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": "363A00000X",
        "TaxonomyName": "Physician Assistant",
        "LicenseNumber": "5737-23",
        "LicenseNumberStateCode": "WI",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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