{
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"EIN": null,
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"Credential": "FNP-C",
"OtherOrgName": null,
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"OtherLastName": "HENLEY",
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"OtherCredential": "RN, CRNP",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "PO BOX 52948",
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"MailingAddressCityName": "KNOXVILLE",
"MailingAddressStateName": "TN",
"MailingAddressPostalCode": "37950-2948",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "865-306-5675",
"MailingAddressFaxNumber": "865-584-7712",
"FirstLinePracticeLocationAddress": "1819 CLINCH AVE STE 200",
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"PracticeLocationAddressCityName": "KNOXVILLE",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "865-524-3695",
"PracticeLocationAddressFaxNumber": "865-602-3528",
"EnumerationDate": "01/09/2019",
"LastUpdateDate": "01/18/2021",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Family Nurse Practitioner",
"LicenseNumber": "0000025020",
"LicenseNumberStateCode": "TN",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}