{
"Npi": {
"NPI": "1619274933",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "WHEELER",
"FirstName": "HOLLIE",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": "FNP",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "CONNER",
"OtherFirstName": "HOLLIE",
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "FNP",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "1523 W BUSINESS HWY 60 1",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "DEXTER",
"MailingAddressStateName": "MO",
"MailingAddressPostalCode": "63841",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "573-614-5762",
"MailingAddressFaxNumber": "573-614-5806",
"FirstLinePracticeLocationAddress": "911B W BUSINESS HWY 60",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "DEXTER",
"PracticeLocationAddressStateName": "MO",
"PracticeLocationAddressPostalCode": "63841-2741",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "573-614-5762",
"PracticeLocationAddressFaxNumber": "573-614-5806",
"EnumerationDate": "02/23/2011",
"LastUpdateDate": "06/14/2023",
"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": "363LF0000X",
"TaxonomyName": "Family Nurse Practitioner",
"LicenseNumber": "2011003525",
"LicenseNumberStateCode": "MO",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}