{
"Npi": {
"NPI": "1093830481",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "NUNNERY",
"FirstName": "MARIENA",
"MiddleName": "LOUISE",
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "4145 SHADOW LN",
"SecondLineMailingAddress": "APT.#527",
"MailingAddressCityName": "SANTA ROSA",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "95405-5265",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "915-345-4077",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "599 TOMALES",
"SecondLinePracticeLocationAddress": "CLINIC",
"PracticeLocationAddressCityName": "PETALUMA",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "94952-5000",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "707-765-7200",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "03/21/2007",
"LastUpdateDate": "07/08/2007",
"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": "246QM0706X",
"TaxonomyName": "Medical Technologist",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}