{
"Npi": {
"NPI": "1043570997",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "TUCKER",
"FirstName": "AUGUSTA",
"MiddleName": "HAWA",
"NamePrefix": "MISS",
"NameSuffix": null,
"Credential": "LPN",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "TUCKER",
"OtherFirstName": "AUGUSTA",
"OtherMiddleName": "HAWA",
"OtherNamePrefix": "MISS",
"OtherNameSuffix": null,
"OtherCredential": "LPN",
"OtherLastNameTypeCode": "5",
"FirstLineMailingAddress": "6700 BELCREST RD",
"SecondLineMailingAddress": "APT 321",
"MailingAddressCityName": "HYATTSVILLE",
"MailingAddressStateName": "MD",
"MailingAddressPostalCode": "20782-1398",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "240-305-4234",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "6700 BELCREST RD",
"SecondLinePracticeLocationAddress": "APT 321",
"PracticeLocationAddressCityName": "HYATTSVILLE",
"PracticeLocationAddressStateName": "MD",
"PracticeLocationAddressPostalCode": "20782-1398",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "240-305-4234",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "05/25/2012",
"LastUpdateDate": "05/25/2012",
"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": "LP43064",
"LicenseNumberStateCode": "MD",
"PrimaryTaxonomySwitch": "Y"
},
{
"TaxonomyCode": "164W00000X",
"TaxonomyName": "Licensed Practical Nurse",
"LicenseNumber": "LPN1003906",
"LicenseNumberStateCode": "DC",
"PrimaryTaxonomySwitch": "N"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}