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1790313419 NPI number — SHELLIE MARTHINI ARNP

NPI Number: 1790313419
Health Care Provider/Practitioner: SHELLIE MARTHINI ARNP

Information about “1790313419” NPI (SHELLIE MARTHINI ARNP) exists in 1790313419 in HTML format HTML  |  1790313419 in plain Text format TXT  |  1790313419 in PDF (Portable Document Format) PDF  |  1790313419 in an XML format XML  formats.

NPI Number : 1790313419 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1790313419",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MARTHINI",
    "FirstName": "SHELLIE",
    "MiddleName": null,
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "ARNP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1024 BEANE RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "MOXEE",
    "MailingAddressStateName": "WA",
    "MailingAddressPostalCode": "98936-9750",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "509-948-2252",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "560 GAGE BLVD STE 102",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "RICHLAND",
    "PracticeLocationAddressStateName": "WA",
    "PracticeLocationAddressPostalCode": "99352-9531",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "509-942-3135",
    "PracticeLocationAddressFaxNumber": "509-627-1188",
    "EnumerationDate": "03/29/2020",
    "LastUpdateDate": "11/13/2024",
    "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": "363LA2200X",
          "TaxonomyName": "Adult Health Nurse Practitioner",
          "LicenseNumber": "AP61059985",
          "LicenseNumberStateCode": "WA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LP2300X",
          "TaxonomyName": "Primary Care Nurse Practitioner",
          "LicenseNumber": "AP61059985",
          "LicenseNumberStateCode": "WA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LG0600X",
          "TaxonomyName": "Gerontology Nurse Practitioner",
          "LicenseNumber": "AP61059985",
          "LicenseNumberStateCode": "WA",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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