{
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"OtherLastName": "SHIVELY",
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"FirstLineMailingAddress": "3931 CYNTHIA DR",
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"MailingAddressCountryCode": "US",
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"FirstLinePracticeLocationAddress": "1375 CY AVE",
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"PracticeLocationAddressTelephoneNumber": "307-234-7949",
"PracticeLocationAddressFaxNumber": "307-234-0393",
"EnumerationDate": "11/05/2010",
"LastUpdateDate": "11/05/2010",
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"NPIReactivationDate": null,
"GenderCode": "F",
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"Taxonomies": {
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}
},
"HealthcareProviderTaxonomyGroups": null
}
}