{
"Npi": {
"NPI": "1356742043",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "JENKINS",
"FirstName": "QUALYNN",
"MiddleName": "S.",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "APRN FNP-C",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "JENKINS",
"OtherFirstName": "QUA'LYNN",
"OtherMiddleName": "S.",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "LPC",
"OtherLastNameTypeCode": "2",
"FirstLineMailingAddress": "2529 LAKE ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LAKE CHARLES",
"MailingAddressStateName": "LA",
"MailingAddressPostalCode": "70601-8211",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "337-912-9758",
"MailingAddressFaxNumber": "337-735-9760",
"FirstLinePracticeLocationAddress": "2529 LAKE ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LAKE CHARLES",
"PracticeLocationAddressStateName": "LA",
"PracticeLocationAddressPostalCode": "70601-8211",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "337-912-9758",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "09/12/2014",
"LastUpdateDate": "09/17/2025",
"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": "101Y00000X",
"TaxonomyName": "Counselor",
"LicenseNumber": "AP08021",
"LicenseNumberStateCode": "LA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "363LF0000X",
"TaxonomyName": "Family Nurse Practitioner",
"LicenseNumber": "AP08021",
"LicenseNumberStateCode": "LA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "363LP0808X",
"TaxonomyName": "Psychiatric/Mental Health Nurse Practitioner",
"LicenseNumber": "AP08021",
"LicenseNumberStateCode": "LA",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}