{
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"FirstLineMailingAddress": "630 CREEKVIEW BLVD",
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"FirstLinePracticeLocationAddress": "1670 CLAIRMONT RD",
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"PracticeLocationAddressFaxNumber": "404-329-4632",
"EnumerationDate": "06/29/2006",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
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"AuthorizedOfficialLastName": "JACOBS",
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"AuthorizedOfficialCredential": "RN",
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"TaxonomyName": "Ambulatory Care Registered Nurse",
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}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}