{
"Npi": {
"NPI": "1497213094",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "OLEPERE",
"FirstName": "JUDITH",
"MiddleName": "WANGARI",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "PMHNP-BC, MSN",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "NJOGU",
"OtherFirstName": "JUDITH",
"OtherMiddleName": "WANGARI",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "1920 N COIT RD STE 219",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "RICHARDSON",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "75080-2832",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "214-744-5438",
"MailingAddressFaxNumber": "972-478-0554",
"FirstLinePracticeLocationAddress": "1920 N COIT RD STE 219",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "RICHARDSON",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "75080-2832",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "214-744-5438",
"PracticeLocationAddressFaxNumber": "972-478-5438",
"EnumerationDate": "03/04/2019",
"LastUpdateDate": "10/02/2024",
"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": "363LP0808X",
"TaxonomyName": "Psychiatric/Mental Health Nurse Practitioner",
"LicenseNumber": "AP140851",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
},
{
"TaxonomyCode": "363LP0808X",
"TaxonomyName": "Psychiatric/Mental Health Nurse Practitioner",
"LicenseNumber": "AP61355142",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "N"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}