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1780058024 NPI number — MARIA JELINEK

NPI Number: 1780058024
Health Care Provider/Practitioner: MARIA JELINEK

Information about “1780058024” NPI (MARIA JELINEK) exists in 1780058024 in HTML format HTML  |  1780058024 in plain Text format TXT  |  1780058024 in PDF (Portable Document Format) PDF  |  1780058024 in an XML format XML  formats.

NPI Number : 1780058024 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1780058024",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "JELINEK",
    "FirstName": "MARIA",
    "MiddleName": null,
    "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": "802 W DRAKE RD STE 133A",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "FORT COLLINS",
    "MailingAddressStateName": "CO",
    "MailingAddressPostalCode": "80526-5567",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "970-494-6449",
    "MailingAddressFaxNumber": "970-494-6447",
    "FirstLinePracticeLocationAddress": "802 W DRAKE RD STE 133A",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "FORT COLLINS",
    "PracticeLocationAddressStateName": "CO",
    "PracticeLocationAddressPostalCode": "80526-5567",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "970-494-6449",
    "PracticeLocationAddressFaxNumber": "970-494-6447",
    "EnumerationDate": "11/24/2015",
    "LastUpdateDate": "11/24/2015",
    "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": "225X00000X",
        "TaxonomyName": "Occupational Therapist",
        "LicenseNumber": "659",
        "LicenseNumberStateCode": "CO",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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