NPI Code Detail JSON Logo

1831102839 NPI number — NICOLE ENGLUND HEFFRON NICOLE HEFFRON

NPI Number: 1831102839
Health Care Provider/Practitioner: NICOLE ENGLUND HEFFRON NICOLE HEFFRON

Information about “1831102839” NPI (NICOLE ENGLUND HEFFRON NICOLE HEFFRON) exists in 1831102839 in HTML format HTML  |  1831102839 in plain Text format TXT  |  1831102839 in PDF (Portable Document Format) PDF  |  1831102839 in an XML format XML  formats.

NPI Number : 1831102839 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1831102839",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "HEFFRON",
    "FirstName": "NICOLE",
    "MiddleName": "ENGLUND",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "NICOLE HEFFRON",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "ENGLUND",
    "OtherFirstName": "NICOLE",
    "OtherMiddleName": "LYNN",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "PH.D.",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "630 3RD AVE SE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "MINNEAPOLIS",
    "MailingAddressStateName": "MN",
    "MailingAddressPostalCode": "55414-1604",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "612-688-3602",
    "MailingAddressFaxNumber": "855-538-9398",
    "FirstLinePracticeLocationAddress": "23 4TH ST SE STE 216",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "MINNEAPOLIS",
    "PracticeLocationAddressStateName": "MN",
    "PracticeLocationAddressPostalCode": "55414-1069",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "651-224-1541",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "08/14/2006",
    "LastUpdateDate": "06/24/2025",
    "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": "103TC0700X",
        "TaxonomyName": "Clinical Psychologist",
        "LicenseNumber": "LP4508",
        "LicenseNumberStateCode": "MN",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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