{
"Npi": {
"NPI": "1205261724",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "CLEVELAND",
"FirstName": "MICHELLE",
"MiddleName": "LEE",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "NP",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "N6317 JOHNSON RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "DELAVAN",
"MailingAddressStateName": "WI",
"MailingAddressPostalCode": "53115-2778",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "262-812-7819",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "3401 N PERRYVILLE RD",
"SecondLinePracticeLocationAddress": "SUITE 303",
"PracticeLocationAddressCityName": "ROCKFORD",
"PracticeLocationAddressStateName": "IL",
"PracticeLocationAddressPostalCode": "61114-8011",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "815-971-1060",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "09/04/2013",
"LastUpdateDate": "09/04/2013",
"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": "209.010685041.383842",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}