{
"Npi": {
"NPI": "1609046143",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "KEANE",
"FirstName": "ERIN",
"MiddleName": "MULLANEY",
"NamePrefix": "MS.",
"NameSuffix": null,
"Credential": "RN, PPCNP-BC",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "MULLANEY",
"OtherFirstName": "ERIN",
"OtherMiddleName": "KATHLEEN",
"OtherNamePrefix": "MS.",
"OtherNameSuffix": null,
"OtherCredential": "RN, PPCNP-BC",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "2200 WHITNEY AVE STE 240",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HAMDEN",
"MailingAddressStateName": "CT",
"MailingAddressPostalCode": "06518-3602",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "203-287-5400",
"MailingAddressFaxNumber": "203-281-3001",
"FirstLinePracticeLocationAddress": "2200 WHITNEY AVE STE 240",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "HAMDEN",
"PracticeLocationAddressStateName": "CT",
"PracticeLocationAddressPostalCode": "06518-3602",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "203-287-5400",
"PracticeLocationAddressFaxNumber": "203-381-3001",
"EnumerationDate": "03/11/2008",
"LastUpdateDate": "09/06/2023",
"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": "363LP0200X",
"TaxonomyName": "Pediatric Nurse Practitioner",
"LicenseNumber": "12.009460",
"LicenseNumberStateCode": "CT",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}