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1871595421 NPI number — LISA MAE RUPERT MSN FNP

NPI Number: 1871595421
Health Care Provider/Practitioner: LISA MAE RUPERT MSN FNP

Information about “1871595421” NPI (LISA MAE RUPERT MSN FNP) exists in 1871595421 in HTML format HTML  |  1871595421 in plain Text format TXT  |  1871595421 in PDF (Portable Document Format) PDF  |  1871595421 in an XML format XML  formats.

NPI Number : 1871595421 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1871595421",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "RUPERT",
    "FirstName": "LISA",
    "MiddleName": "MAE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "MSN FNP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "MCLAUGHLIN",
    "OtherFirstName": "LISA",
    "OtherMiddleName": "MAE",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "8170 33RD AVE S",
    "SecondLineMailingAddress": "MS21110Q",
    "MailingAddressCityName": "MINNEAPOLIS",
    "MailingAddressStateName": "MN",
    "MailingAddressPostalCode": "55425-4516",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "952-883-5375",
    "MailingAddressFaxNumber": "952-883-5395",
    "FirstLinePracticeLocationAddress": "8170 33RD AVE S MS 21110Q",
    "SecondLinePracticeLocationAddress": "HEALTHPARTNERS FLOATING CLINIC C/O PHYSICIAN SERVICES",
    "PracticeLocationAddressCityName": "MINNEAPOLIS",
    "PracticeLocationAddressStateName": "MN",
    "PracticeLocationAddressPostalCode": "55440-1309",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "952-883-5375",
    "PracticeLocationAddressFaxNumber": "952-883-5395",
    "EnumerationDate": "08/12/2005",
    "LastUpdateDate": "12/05/2011",
    "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": "363L00000X",
        "TaxonomyName": "Nurse Practitioner",
        "LicenseNumber": "R165885-9",
        "LicenseNumberStateCode": "MN",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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