{
"Npi": {
"NPI": "1093249880",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "MARSHALL",
"FirstName": "TRICIA",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "GREGORY",
"OtherFirstName": "TRICIA",
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "NP",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "2401 SEABOARD RD STE 105",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "VIRGINIA BEACH",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "23456-3500",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "757-430-4270",
"MailingAddressFaxNumber": "949-695-3748",
"FirstLinePracticeLocationAddress": "2401 SEABOARD RD STE 105",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "VA BEACH",
"PracticeLocationAddressStateName": "VA",
"PracticeLocationAddressPostalCode": "23456-3500",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "757-430-4270",
"PracticeLocationAddressFaxNumber": "949-695-3748",
"EnumerationDate": "04/18/2017",
"LastUpdateDate": "03/03/2025",
"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": "363LP0808X",
"TaxonomyName": "Psychiatric/Mental Health Nurse Practitioner",
"LicenseNumber": "0024174747",
"LicenseNumberStateCode": "VA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "363LF0000X",
"TaxonomyName": "Family Nurse Practitioner",
"LicenseNumber": "0024174747",
"LicenseNumberStateCode": "VA",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}