{
"Npi": {
"NPI": "1023252707",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "WALLEN",
"FirstName": "TRAM",
"MiddleName": "T",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "DNP, APRN, C-NP",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "841 N PIMA RD.",
"SecondLineMailingAddress": "STE. 210",
"MailingAddressCityName": "SCOTTSDALE",
"MailingAddressStateName": "AZ",
"MailingAddressPostalCode": "85258",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "480-425-8700",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1 PARKVIEW PL # 6800-P",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SAINT LOUIS",
"PracticeLocationAddressStateName": "MO",
"PracticeLocationAddressPostalCode": "63110-1038",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "314-362-1388",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "04/27/2009",
"LastUpdateDate": "09/03/2025",
"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": "363L00000X",
"TaxonomyName": "Nurse Practitioner",
"LicenseNumber": "258169",
"LicenseNumberStateCode": "AZ",
"PrimaryTaxonomySwitch": "Y"
},
{
"TaxonomyCode": "363LW0102X",
"TaxonomyName": "Women's Health Nurse Practitioner",
"LicenseNumber": "2004020175",
"LicenseNumberStateCode": "MO",
"PrimaryTaxonomySwitch": "N"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}