{
"Npi": {
"NPI": "1558651513",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "MCNEIL",
"FirstName": "DINA",
"MiddleName": "ELAINE",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "DNP, ARNP",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "2758 78TH AVE SE APT C412",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MERCER ISLAND",
"MailingAddressStateName": "WA",
"MailingAddressPostalCode": "98040-3565",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "206-867-5005",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "7683 SE 27TH ST # 294",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MERCER ISLAND",
"PracticeLocationAddressStateName": "WA",
"PracticeLocationAddressPostalCode": "98040-2804",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "206-867-5005",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "04/12/2011",
"LastUpdateDate": "10/24/2024",
"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": "363LF0000X",
"TaxonomyName": "Family Nurse Practitioner",
"LicenseNumber": "ARNP9263135",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "363LP0808X",
"TaxonomyName": "Psychiatric/Mental Health Nurse Practitioner",
"LicenseNumber": "AP60635951",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "Y"
},
{
"TaxonomyCode": "363LF0000X",
"TaxonomyName": "Family Nurse Practitioner",
"LicenseNumber": "AP60635951",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "N"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}