{
"Npi": {
"NPI": "1184158230",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "BOULAY",
"FirstName": "CAROL",
"MiddleName": "ANNE",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "ARNP",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "6198 52ND ST S",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ST PETERSBURG",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33715-2405",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "727-409-9211",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "6198 52ND ST S",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ST PETERSBURG",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "33715-2405",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "727-409-9211",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "04/16/2017",
"LastUpdateDate": "04/16/2017",
"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": "363LA2200X",
"TaxonomyName": "Adult Health Nurse Practitioner",
"LicenseNumber": "1756222",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
},
{
"TaxonomyCode": "363LG0600X",
"TaxonomyName": "Gerontology Nurse Practitioner",
"LicenseNumber": "1756222",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "N"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}