{
"Npi": {
"NPI": "1114465325",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "MARTIN",
"FirstName": "STEPHANIE",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": "CNP",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "10058 COOLEY RD",
"SecondLineMailingAddress": "STE 6",
"MailingAddressCityName": "BROOKVILLE",
"MailingAddressStateName": "IN",
"MailingAddressPostalCode": "47012-9509",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "765-647-0808",
"MailingAddressFaxNumber": "795-647-2728",
"FirstLinePracticeLocationAddress": "5151 MORNING SUN RD STE B",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "OXFORD",
"PracticeLocationAddressStateName": "OH",
"PracticeLocationAddressPostalCode": "45056-9546",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "513-524-5522",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "02/08/2017",
"LastUpdateDate": "09/24/2025",
"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": "363LF0000X",
"TaxonomyName": "Family Nurse Practitioner",
"LicenseNumber": "020392",
"LicenseNumberStateCode": "OH",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}