{
"Npi": {
"NPI": "1164842696",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "YANEZ",
"FirstName": "GRETCHEN",
"MiddleName": "MERTZ",
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "BARR",
"OtherFirstName": "GRETCHEN",
"OtherMiddleName": "MERTZ",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "788 CRYSTAL WATER WAY",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MYRTLE BEACH",
"MailingAddressStateName": "SC",
"MailingAddressPostalCode": "29579-4381",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "843-231-2629",
"MailingAddressFaxNumber": "843-281-8176",
"FirstLinePracticeLocationAddress": "2751 BEAVER RUN BLVD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SURFSIDE BEACH",
"PracticeLocationAddressStateName": "SC",
"PracticeLocationAddressPostalCode": "29575-5385",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "843-215-3856",
"PracticeLocationAddressFaxNumber": "843-215-3856",
"EnumerationDate": "04/23/2014",
"LastUpdateDate": "05/16/2025",
"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": "183500000X",
"TaxonomyName": "Pharmacist",
"LicenseNumber": "10843",
"LicenseNumberStateCode": "SC",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}