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1871036327 NPI number — KELLI REYNOLDS WOHLGEMUTH FNP

NPI Number: 1871036327
Health Care Provider/Practitioner: KELLI REYNOLDS WOHLGEMUTH FNP

Information about “1871036327” NPI (KELLI REYNOLDS WOHLGEMUTH FNP) exists in 1871036327 in HTML format HTML  |  1871036327 in plain Text format TXT  |  1871036327 in PDF (Portable Document Format) PDF  |  1871036327 in an XML format XML  formats.

NPI Number : 1871036327 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1871036327",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "WOHLGEMUTH",
    "FirstName": "KELLI",
    "MiddleName": "REYNOLDS",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "FNP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "REYNOLDS",
    "OtherFirstName": "KELLI",
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "FNP-C",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "9200 PINECROFT DR STE 255",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SHENANDOAH",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "77380-3286",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "281-419-8400",
    "MailingAddressFaxNumber": "281-292-1972",
    "FirstLinePracticeLocationAddress": "9200 PINECROFT DR STE 255",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SHENANDOAH",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "77380-3286",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "281-419-8400",
    "PracticeLocationAddressFaxNumber": "281-292-1972",
    "EnumerationDate": "11/30/2016",
    "LastUpdateDate": "01/18/2024",
    "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": "363LF0000X",
        "TaxonomyName": "Family Nurse Practitioner",
        "LicenseNumber": "AP132422",
        "LicenseNumberStateCode": "TX",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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