{
"Npi": {
"NPI": "1619301363",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "LOPEZ",
"FirstName": "ANDREA",
"MiddleName": "MICHAELENA",
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": "RN, CRNP",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "50 E MAIN ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HARRINGTON",
"MailingAddressStateName": "ME",
"MailingAddressPostalCode": "04643-3043",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "207-483-4502",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "10 MINES RD STE H3",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BLUE HILL",
"PracticeLocationAddressStateName": "ME",
"PracticeLocationAddressPostalCode": "04614-6408",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "207-610-0127",
"PracticeLocationAddressFaxNumber": "781-291-4465",
"EnumerationDate": "08/29/2013",
"LastUpdateDate": "03/12/2025",
"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": "363LP0808X",
"TaxonomyName": "Psychiatric/Mental Health Nurse Practitioner",
"LicenseNumber": "SP013140",
"LicenseNumberStateCode": "PA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "363LP0808X",
"TaxonomyName": "Psychiatric/Mental Health Nurse Practitioner",
"LicenseNumber": "R183798",
"LicenseNumberStateCode": "MD",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "363LP0808X",
"TaxonomyName": "Psychiatric/Mental Health Nurse Practitioner",
"LicenseNumber": "CNP191220",
"LicenseNumberStateCode": "ME",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}