{
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"EIN": null,
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"NameSuffix": null,
"Credential": "ACNP",
"OtherOrgName": null,
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"OtherLastName": "RODGERS",
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"FirstLineMailingAddress": "2205 E. 70TH STREET",
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"MailingAddressCityName": "SHREVEPORT",
"MailingAddressStateName": "LA",
"MailingAddressPostalCode": "71105-3813",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "318-797-1585",
"MailingAddressFaxNumber": "318-797-6077",
"FirstLinePracticeLocationAddress": "2205 E 70TH ST",
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"PracticeLocationAddressCityName": "SHREVEPORT",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "318-797-1585",
"PracticeLocationAddressFaxNumber": "318-797-6077",
"EnumerationDate": "11/03/2010",
"LastUpdateDate": "04/09/2019",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Nurse Practitioner",
"LicenseNumber": "AP06053",
"LicenseNumberStateCode": "LA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}