{
"Npi": {
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"EIN": null,
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"NameSuffix": null,
"Credential": "FNP-C",
"OtherOrgName": null,
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"OtherLastName": "FAULK SMITH",
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"OtherCredential": "RN",
"OtherLastNameTypeCode": "2",
"FirstLineMailingAddress": "905 N LIBERTY ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "NICHOLLS",
"MailingAddressStateName": "GA",
"MailingAddressPostalCode": "31554-4016",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "912-921-3772",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "201 N BARTOW ST",
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"PracticeLocationAddressCityName": "NASHVILLE",
"PracticeLocationAddressStateName": "GA",
"PracticeLocationAddressPostalCode": "31639-1435",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "229-686-2774",
"PracticeLocationAddressFaxNumber": "229-543-1348",
"EnumerationDate": "12/29/2016",
"LastUpdateDate": "11/12/2019",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
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"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "363LF0000X",
"TaxonomyName": "Family Nurse Practitioner",
"LicenseNumber": "RN089891",
"LicenseNumberStateCode": "GA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}