{
"Npi": {
"NPI": "1568034502",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "JONES",
"FirstName": "ANGELA",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": "NP",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "204 S FRONT ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "WINONA",
"MailingAddressStateName": "MS",
"MailingAddressPostalCode": "38967-2557",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "662-508-5008",
"MailingAddressFaxNumber": "662-508-5053",
"FirstLinePracticeLocationAddress": "204 S FRONT ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "WINONA",
"PracticeLocationAddressStateName": "MS",
"PracticeLocationAddressPostalCode": "38967-2557",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "662-508-5008",
"PracticeLocationAddressFaxNumber": "662-508-5053",
"EnumerationDate": "07/09/2021",
"LastUpdateDate": "07/15/2023",
"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": "163WD0400X",
"TaxonomyName": "Diabetes Educator Registered Nurse",
"LicenseNumber": "862847",
"LicenseNumberStateCode": "MS",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "363LF0000X",
"TaxonomyName": "Family Nurse Practitioner",
"LicenseNumber": "904833",
"LicenseNumberStateCode": "MS",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}