{
"Npi": {
"NPI": "1598826919",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "SULLIVAN",
"FirstName": "REBECCA",
"MiddleName": "A.",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "CRNA",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "BIANCHIN",
"OtherFirstName": "REBECCA",
"OtherMiddleName": "A.",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "1613 HARRISON PKWY",
"SecondLineMailingAddress": "SUITE 200, MAILSTOP SH-9A",
"MailingAddressCityName": "SUNRISE",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33323-2896",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "800-437-2672",
"MailingAddressFaxNumber": "954-851-1746",
"FirstLinePracticeLocationAddress": "532 WEST PITTSBURGH STREET",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "GREENSBURG",
"PracticeLocationAddressStateName": "PA",
"PracticeLocationAddressPostalCode": "15601",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "724-832-4036",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "12/12/2006",
"LastUpdateDate": "04/05/2013",
"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": "163W00000X",
"TaxonomyName": "Registered Nurse",
"LicenseNumber": "RN513035L",
"LicenseNumberStateCode": "PA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "367500000X",
"TaxonomyName": "Certified Registered Nurse Anesthetist",
"LicenseNumber": "R204926",
"LicenseNumberStateCode": "MD",
"PrimaryTaxonomySwitch": "Y"
},
{
"TaxonomyCode": "367500000X",
"TaxonomyName": "Certified Registered Nurse Anesthetist",
"LicenseNumber": "RN513035L",
"LicenseNumberStateCode": "PA",
"PrimaryTaxonomySwitch": "N"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}