{
"Npi": {
"NPI": "1649235284",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "WILKIN",
"FirstName": "AMY",
"MiddleName": "LOUISE",
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": "A.T.,C.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "HERRERA",
"OtherFirstName": "AMY",
"OtherMiddleName": "LOUISE",
"OtherNamePrefix": "MISS",
"OtherNameSuffix": null,
"OtherCredential": "A.T.,C.",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "18422 BEAR VALLEY RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "VICTORVILLE",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92395-5850",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "760-245-4271",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "18422 BEAR VALLEY RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "VICTORVILLE",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "92395-5850",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "760-245-4271",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "04/18/2006",
"LastUpdateDate": "02/12/2025",
"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": "2255A2300X",
"TaxonomyName": "Athletic Trainer",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}