{
"Npi": {
"NPI": "1033355383",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "WILK",
"FirstName": "ZOFIA",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": "FNP-BC",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "MALISZEWSKA",
"OtherFirstName": "ZOFIA",
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "NURSE PRACTITIONER",
"OtherLastNameTypeCode": "5",
"FirstLineMailingAddress": "13945 W GRAND AVE STE 105",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SURPRISE",
"MailingAddressStateName": "AZ",
"MailingAddressPostalCode": "85374-2437",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "623-546-0007",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "13945 W GRAND AVE STE 105",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SURPRISE",
"PracticeLocationAddressStateName": "AZ",
"PracticeLocationAddressPostalCode": "85374-2437",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "623-546-0007",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "12/16/2008",
"LastUpdateDate": "12/26/2016",
"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": "363LF0000X",
"TaxonomyName": "Family Nurse Practitioner",
"LicenseNumber": "AP3196",
"LicenseNumberStateCode": "AZ",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}