{
"Npi": {
"NPI": "1255521548",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "MCKIBBIN",
"FirstName": "CHILLON",
"MiddleName": "A",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "CNM",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "610 30TH AVENUE WEST",
"SecondLineMailingAddress": "ALEXANDRIA CLINIC",
"MailingAddressCityName": "ALEXANDRIA",
"MailingAddressStateName": "MN",
"MailingAddressPostalCode": "56308",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "320-763-5123",
"MailingAddressFaxNumber": "320-763-7883",
"FirstLinePracticeLocationAddress": "111 17TH AVE E",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ALEXANDRIA",
"PracticeLocationAddressStateName": "MN",
"PracticeLocationAddressPostalCode": "56308-5273",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "320-763-2707",
"PracticeLocationAddressFaxNumber": "320-759-4395",
"EnumerationDate": "08/01/2007",
"LastUpdateDate": "10/15/2025",
"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": "176B00000X",
"TaxonomyName": "Midwife",
"LicenseNumber": "R1567047",
"LicenseNumberStateCode": "MN",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}