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1952805590 NPI number — JULIANNA WITTRUP OTR/L

NPI Number: 1952805590
Health Care Provider/Practitioner: JULIANNA WITTRUP OTR/L

Information about “1952805590” NPI (JULIANNA WITTRUP OTR/L) exists in 1952805590 in HTML format HTML  |  1952805590 in plain Text format TXT  |  1952805590 in PDF (Portable Document Format) PDF  |  1952805590 in an XML format XML  formats.

NPI Number : 1952805590 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1952805590",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "WITTRUP",
    "FirstName": "JULIANNA",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "OTR/L",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "WITTRUP",
    "OtherFirstName": "LISA",
    "OtherMiddleName": "J",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "OTR/L",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "11830 N 75TH ST UNIT 384",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "HYGIENE",
    "MailingAddressStateName": "CO",
    "MailingAddressPostalCode": "80533-7417",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "808-359-3374",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1000 GREG KRUSCHEK AVENUE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "NOME",
    "PracticeLocationAddressStateName": "AK",
    "PracticeLocationAddressPostalCode": "99762-0966",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "907-443-3311",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "03/20/2018",
    "LastUpdateDate": "07/30/2025",
    "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": "225X00000X",
          "TaxonomyName": "Occupational Therapist",
          "LicenseNumber": "OT.60913624",
          "LicenseNumberStateCode": "WA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "225X00000X",
          "TaxonomyName": "Occupational Therapist",
          "LicenseNumber": "OT.16182",
          "LicenseNumberStateCode": "CA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "225X00000X",
          "TaxonomyName": "Occupational Therapist",
          "LicenseNumber": "OT.0004576",
          "LicenseNumberStateCode": "CO",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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