{
"Npi": {
"NPI": "1124567557",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "TUCKER",
"FirstName": "DIANE",
"MiddleName": "C",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "NP",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "TUCKER",
"OtherFirstName": "VIRGINIA",
"OtherMiddleName": "DIANE",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "NP",
"OtherLastNameTypeCode": "5",
"FirstLineMailingAddress": "16000 JOHNSTON MEMORIAL DR",
"SecondLineMailingAddress": "SUITE 212A",
"MailingAddressCityName": "ABINGDON",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "24211-7664",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "276-258-3740",
"MailingAddressFaxNumber": "276-258-3745",
"FirstLinePracticeLocationAddress": "16000 JOHNSTON MEMORIAL DR",
"SecondLinePracticeLocationAddress": "SUITE 212A",
"PracticeLocationAddressCityName": "ABINGDON",
"PracticeLocationAddressStateName": "VA",
"PracticeLocationAddressPostalCode": "24211-7664",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "276-258-3740",
"PracticeLocationAddressFaxNumber": "276-258-3745",
"EnumerationDate": "02/17/2017",
"LastUpdateDate": "03/23/2017",
"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": "0024174575",
"LicenseNumberStateCode": "VA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}