NPI Code Detail JSON Logo

1730709007 NPI number — LISA JOY KLEIN-CONRAD

NPI Number: 1730709007
Health Care Provider/Practitioner: LISA JOY KLEIN-CONRAD

Information about “1730709007” NPI (LISA JOY KLEIN-CONRAD) exists in 1730709007 in HTML format HTML  |  1730709007 in plain Text format TXT  |  1730709007 in PDF (Portable Document Format) PDF  |  1730709007 in an XML format XML  formats.

NPI Number : 1730709007 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1730709007",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "KLEIN-CONRAD",
    "FirstName": "LISA",
    "MiddleName": "JOY",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "204 10TH AVE N",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "COLD SPRING",
    "MailingAddressStateName": "MN",
    "MailingAddressPostalCode": "56320-1229",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "320-291-1831",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "117 W JAMES ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "PAYNESVILLE",
    "PracticeLocationAddressStateName": "MN",
    "PracticeLocationAddressPostalCode": "56362-1216",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "320-243-3379",
    "PracticeLocationAddressFaxNumber": "320-243-3138",
    "EnumerationDate": "04/16/2020",
    "LastUpdateDate": "04/16/2020",
    "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": "101YA0400X",
        "TaxonomyName": "Addiction (Substance Use Disorder) Counselor",
        "LicenseNumber": "302590",
        "LicenseNumberStateCode": "MN",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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