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1912315029 NPI number — DAISY CRYSTAL MARIE MARCUS LPN

NPI Number: 1912315029
Health Care Provider/Practitioner: DAISY CRYSTAL MARIE MARCUS LPN

Information about “1912315029” NPI (DAISY CRYSTAL MARIE MARCUS LPN) exists in 1912315029 in HTML format HTML  |  1912315029 in plain Text format TXT  |  1912315029 in PDF (Portable Document Format) PDF  |  1912315029 in an XML format XML  formats.

NPI Number : 1912315029 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1912315029",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MARCUS",
    "FirstName": "DAISY",
    "MiddleName": "CRYSTAL MARIE",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "LPN",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "RYSER",
    "OtherFirstName": "DAISY",
    "OtherMiddleName": "CRYSTAL MARIE",
    "OtherNamePrefix": "MISS",
    "OtherNameSuffix": null,
    "OtherCredential": "LPN",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "2672 TWO RIDGE AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "LANCASTER",
    "MailingAddressStateName": "OH",
    "MailingAddressPostalCode": "43130-7821",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "740-409-2449",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "2672 TWO RIDGE AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LANCASTER",
    "PracticeLocationAddressStateName": "OH",
    "PracticeLocationAddressPostalCode": "43130-7821",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "740-409-2449",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "08/01/2014",
    "LastUpdateDate": "08/01/2014",
    "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": "164W00000X",
        "TaxonomyName": "Licensed Practical Nurse",
        "LicenseNumber": "151818",
        "LicenseNumberStateCode": "OK",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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