{
"Npi": {
"NPI": "1043342785",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "MONROE",
"FirstName": "CHRISTY",
"MiddleName": "M",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "LPN",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "DAILEY",
"OtherFirstName": "CHRISTY",
"OtherMiddleName": "M",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "LPN",
"OtherLastNameTypeCode": "5",
"FirstLineMailingAddress": "2416 SOUTHVIEW DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MARYVILLE",
"MailingAddressStateName": "TN",
"MailingAddressPostalCode": "37803-6635",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "865-684-3353",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "210 SIMMONS ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MARYVILLE",
"PracticeLocationAddressStateName": "TN",
"PracticeLocationAddressPostalCode": "37801-4750",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "865-374-7100",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "03/09/2007",
"LastUpdateDate": "02/13/2025",
"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": "164W00000X",
"TaxonomyName": "Licensed Practical Nurse",
"LicenseNumber": "61265",
"LicenseNumberStateCode": "TN",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "164W00000X",
"TaxonomyName": "Licensed Practical Nurse",
"LicenseNumber": "0000061265",
"LicenseNumberStateCode": "TN",
"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."
}
}
}
}