{
"Npi": {
"NPI": "1265024517",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "COLEMAN",
"FirstName": "STANCY",
"MiddleName": "TOMEKIO",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "APRN, PMHNP-BC",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1958 E 70TH ST STE A",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SHREVEPORT",
"MailingAddressStateName": "LA",
"MailingAddressPostalCode": "71105-5339",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "318-540-7330",
"MailingAddressFaxNumber": "318-795-8186",
"FirstLinePracticeLocationAddress": "6015 HEARNE AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SHREVEPORT",
"PracticeLocationAddressStateName": "LA",
"PracticeLocationAddressPostalCode": "71108-3803",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "318-213-0904",
"PracticeLocationAddressFaxNumber": "318-213-1338",
"EnumerationDate": "02/08/2021",
"LastUpdateDate": "10/03/2025",
"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": "363LP0808X",
"TaxonomyName": "Psychiatric/Mental Health Nurse Practitioner",
"LicenseNumber": "218487",
"LicenseNumberStateCode": "LA",
"PrimaryTaxonomySwitch": "Y"
},
{
"TaxonomyCode": "363LF0000X",
"TaxonomyName": "Family Nurse Practitioner",
"LicenseNumber": "218487",
"LicenseNumberStateCode": "LA",
"PrimaryTaxonomySwitch": "N"
}
]
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}