{
"Npi": {
"NPI": "1154850204",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "MARCEL",
"FirstName": "KIMBERLY",
"MiddleName": "LANGHOFF",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "APRHN, FNP-C",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "71107 HIGHWAY 21 STE 2",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "COVINGTON",
"MailingAddressStateName": "LA",
"MailingAddressPostalCode": "70433-7243",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "985-246-5670",
"MailingAddressFaxNumber": "986-246-5667",
"FirstLinePracticeLocationAddress": "15770 PAUL VEGA MD DR STE 204",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "HAMMOND",
"PracticeLocationAddressStateName": "LA",
"PracticeLocationAddressPostalCode": "70403-1475",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "985-230-7860",
"PracticeLocationAddressFaxNumber": "985-230-7861",
"EnumerationDate": "06/11/2017",
"LastUpdateDate": "12/29/2022",
"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": "AP09313",
"LicenseNumberStateCode": "LA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}