{
"Npi": {
"NPI": "1407248461",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "LOUCAS",
"FirstName": "AMINA",
"MiddleName": "RACHEL",
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": "ARNP, FNP-BC",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "GRITSER",
"OtherFirstName": "AMINA",
"OtherMiddleName": null,
"OtherNamePrefix": "MS.",
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "2226 HUALAPAI MOUNTAIN RD",
"SecondLineMailingAddress": "STE 101",
"MailingAddressCityName": "KINGMAN",
"MailingAddressStateName": "AZ",
"MailingAddressPostalCode": "86401-8374",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "305-807-1591",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "4000 NE 170TH ST",
"SecondLinePracticeLocationAddress": "APT 105",
"PracticeLocationAddressCityName": "NORTH MIAMI BEACH",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "33160-3138",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "305-807-1591",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "02/28/2015",
"LastUpdateDate": "07/08/2019",
"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": "363LF0000X",
"TaxonomyName": "Family Nurse Practitioner",
"LicenseNumber": "9288080",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}