{
"Npi": {
"NPI": "1184809691",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "NOLTE",
"FirstName": "KIMBERLY",
"MiddleName": "DAWN",
"NamePrefix": "MS.",
"NameSuffix": null,
"Credential": "NP",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "188 HOSPITAL DR",
"SecondLineMailingAddress": "STE 402",
"MailingAddressCityName": "FAIRHOPE",
"MailingAddressStateName": "AL",
"MailingAddressPostalCode": "36532-2043",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "251-990-1740",
"MailingAddressFaxNumber": "251-990-1747",
"FirstLinePracticeLocationAddress": "150 S INGLESIDE ST STE 6",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "FAIRHOPE",
"PracticeLocationAddressStateName": "AL",
"PracticeLocationAddressPostalCode": "36532-1804",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "251-990-1740",
"PracticeLocationAddressFaxNumber": "251-990-1831",
"EnumerationDate": "01/02/2008",
"LastUpdateDate": "07/11/2019",
"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": "1-072405",
"LicenseNumberStateCode": "AL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}