{
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"FirstLineMailingAddress": "6015 VALENCIA ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LAKE PARK",
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"MailingAddressPostalCode": "31636-3457",
"MailingAddressCountryCode": "US",
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"FirstLinePracticeLocationAddress": "1011 WILLIAMS ST",
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"PracticeLocationAddressCityName": "VALDOSTA",
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"EnumerationDate": "10/23/2015",
"LastUpdateDate": "10/23/2015",
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"NPIReactivationDate": null,
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"AuthorizedOfficialLastName": "COURSON-BIBIN",
"AuthorizedOfficialFirstName": "LAUREN",
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"AuthorizedOfficialCredential": "CNM",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Advanced Practice Midwife",
"LicenseNumber": "RN176291",
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}
},
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}
}
}
}