NPI Code Detail JSON Logo

1861014169 NPI number — MR. TERRANCE THURMER JR.

NPI Number: 1861014169
Health Care Provider/Practitioner: MR. TERRANCE THURMER JR.

Information about “1861014169” NPI (MR. TERRANCE THURMER JR.) exists in 1861014169 in HTML format HTML  |  1861014169 in plain Text format TXT  |  1861014169 in PDF (Portable Document Format) PDF  |  1861014169 in an XML format XML  formats.

NPI Number : 1861014169 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1861014169",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "THURMER",
    "FirstName": "TERRANCE",
    "MiddleName": null,
    "NamePrefix": "MR.",
    "NameSuffix": "JR.",
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "18390 TROTT BROOK PKWY NW",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "ELK RIVER",
    "MailingAddressStateName": "MN",
    "MailingAddressPostalCode": "55330-4660",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "763-245-8796",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "2420 W DIVISION ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SAINT CLOUD",
    "PracticeLocationAddressStateName": "MN",
    "PracticeLocationAddressPostalCode": "56301-3926",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "320-253-5366",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "05/11/2020",
    "LastUpdateDate": "05/11/2020",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "183500000X",
        "TaxonomyName": "Pharmacist",
        "LicenseNumber": "117894",
        "LicenseNumberStateCode": "MN",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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