{
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"FirstLineMailingAddress": "37 CHRISTOPHER DR",
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"MailingAddressStateName": "KY",
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"FirstLinePracticeLocationAddress": "74 BIGGS LN",
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"EnumerationDate": "07/19/2018",
"LastUpdateDate": "07/19/2018",
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"NPIReactivationDate": null,
"GenderCode": null,
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"AuthorizedOfficialLastName": "RYAN",
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"AuthorizedOfficialCredential": "NURSE PRACTITIONER",
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"TaxonomyName": "Family Nurse Practitioner",
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"LicenseNumberStateCode": "KY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}