{
"Npi": {
"NPI": "1790208023",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "GEISERT",
"FirstName": "STACY",
"MiddleName": "TISCIONE",
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": "NP",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "TISCIONE",
"OtherFirstName": "STACY",
"OtherMiddleName": "MARIE",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "NP",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "2218 MOHEGAN DR APT 103",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "FALLS CHURCH",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "22043-3705",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "240-210-3338",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "3800 RESERVOIR ROAD, NW",
"SecondLinePracticeLocationAddress": "LOMBARDI COMPREHENSIVE CANCER CENTER; FIRST FLOOR",
"PracticeLocationAddressCityName": "WASHINGTON",
"PracticeLocationAddressStateName": "DC",
"PracticeLocationAddressPostalCode": "20007",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "202-444-7599",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "07/19/2017",
"LastUpdateDate": "07/21/2022",
"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": "363LF0000X",
"TaxonomyName": "Family Nurse Practitioner",
"LicenseNumber": "RN1030158",
"LicenseNumberStateCode": "DC",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}