{
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"EIN": null,
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"FirstLineMailingAddress": "14415 E BATTLEFIELD PARK RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PRAIRIE GROVE",
"MailingAddressStateName": "AR",
"MailingAddressPostalCode": "72753-9236",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "479-970-1744",
"MailingAddressFaxNumber": "479-878-2555",
"FirstLinePracticeLocationAddress": "1194 W WALNUT ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ROGERS",
"PracticeLocationAddressStateName": "AR",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "479-878-2550",
"PracticeLocationAddressFaxNumber": "479-878-2555",
"EnumerationDate": "10/19/2018",
"LastUpdateDate": "10/19/2018",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Nurse Practitioner",
"LicenseNumber": "A005963",
"LicenseNumberStateCode": "AR",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}