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"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "346-406-5828",
"MailingAddressFaxNumber": "346-406-5821",
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"EnumerationDate": "04/26/2017",
"LastUpdateDate": "09/19/2018",
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"NPIReactivationDate": null,
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"AuthorizedOfficialLastName": "SHELTON",
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"AuthorizedOfficialCredential": "BSN,RN",
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{
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{
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}
}