{
"Npi": {
"NPI": "1295068591",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "BENNETT",
"FirstName": "JOAN",
"MiddleName": "IRENE PERSON",
"NamePrefix": "MS.",
"NameSuffix": null,
"Credential": "DNP, FNP-BC,CRNP-F",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "103 CHESAPEAKE PARK PLZ",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MIDDLE RIVER",
"MailingAddressStateName": "MD",
"MailingAddressPostalCode": "21220-4201",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "410-682-1595",
"MailingAddressFaxNumber": "410-682-2538",
"FirstLinePracticeLocationAddress": "103 CHESAPEAKE PARK PLZ",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MIDDLE RIVER",
"PracticeLocationAddressStateName": "MD",
"PracticeLocationAddressPostalCode": "21220-4201",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "410-682-1595",
"PracticeLocationAddressFaxNumber": "410-682-2538",
"EnumerationDate": "09/17/2009",
"LastUpdateDate": "11/16/2021",
"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": "363L00000X",
"TaxonomyName": "Nurse Practitioner",
"LicenseNumber": "R152891",
"LicenseNumberStateCode": "MD",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}