{
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"FirstLineMailingAddress": "919 HIDDEN RDG",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "IRVING",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "75038-3813",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "469-282-2711",
"MailingAddressFaxNumber": "469-282-0996",
"FirstLinePracticeLocationAddress": "217 SAM HOUSTON JONES PKWY STE 102",
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"PracticeLocationAddressCityName": "LAKE CHARLES",
"PracticeLocationAddressStateName": "LA",
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"PracticeLocationAddressTelephoneNumber": "337-430-4262",
"PracticeLocationAddressFaxNumber": "337-430-4263",
"EnumerationDate": "01/21/2015",
"LastUpdateDate": "03/08/2017",
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"NPIReactivationDate": null,
"GenderCode": "M",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Family Nurse Practitioner",
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"LicenseNumberStateCode": "LA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}