{
"Npi": {
"NPI": "1518783539",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "CARNEY",
"FirstName": "ANGELA",
"MiddleName": "MARIE",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "FNP",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 24981",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BELFAST",
"MailingAddressStateName": "ME",
"MailingAddressPostalCode": "04915-2000",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "844-969-0686",
"MailingAddressFaxNumber": "773-832-7083",
"FirstLinePracticeLocationAddress": "10705 W INDIAN SCHOOL RD STE 100",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "AVONDALE",
"PracticeLocationAddressStateName": "AZ",
"PracticeLocationAddressPostalCode": "85392-5636",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "602-755-0800",
"PracticeLocationAddressFaxNumber": "623-401-1669",
"EnumerationDate": "11/25/2024",
"LastUpdateDate": "07/09/2025",
"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": "317857",
"LicenseNumberStateCode": "AZ",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}