{
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"FirstLineMailingAddress": "624 QUAKER LN",
"SecondLineMailingAddress": "STE. 207C",
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"MailingAddressCountryCode": "US",
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"MailingAddressFaxNumber": "336-883-9728",
"FirstLinePracticeLocationAddress": "218 GATEWOOD AVE",
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"PracticeLocationAddressTelephoneNumber": "336-802-2030",
"PracticeLocationAddressFaxNumber": "336-802-2031",
"EnumerationDate": "04/29/2008",
"LastUpdateDate": "02/09/2015",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Nurse Practitioner",
"LicenseNumber": "400050",
"LicenseNumberStateCode": "NC",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}