{
"Npi": {
"NPI": "1114523420",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "HARSHMAN",
"FirstName": "KRISTIN",
"MiddleName": "NICOLE",
"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": "PO BOX 749495",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ATLANTA",
"MailingAddressStateName": "GA",
"MailingAddressPostalCode": "30374-9495",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "855-963-2100",
"MailingAddressFaxNumber": "813-321-1296",
"FirstLinePracticeLocationAddress": "14543 GLOBAL PARKWAY",
"SecondLinePracticeLocationAddress": "SUITE 110 , 2ND FLOOR",
"PracticeLocationAddressCityName": "FORT MYERS",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "33913-9446",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "239-264-7026",
"PracticeLocationAddressFaxNumber": "239-567-3679",
"EnumerationDate": "12/10/2020",
"LastUpdateDate": "08/08/2024",
"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": "363L00000X",
"TaxonomyName": "Nurse Practitioner",
"LicenseNumber": "APRN11008357",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}