{
"Npi": {
"NPI": "1659261279",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "MABUNAY",
"FirstName": "MELYN",
"MiddleName": "JOY",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "FNP-BC",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "AUTENCIO",
"OtherFirstName": "MELYN",
"OtherMiddleName": "JOY",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "757 E 81ST AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MERRILLVILLE",
"MailingAddressStateName": "IN",
"MailingAddressPostalCode": "46410-5538",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "219-472-0379",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "757 E 81ST AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MERRILLVILLE",
"PracticeLocationAddressStateName": "IN",
"PracticeLocationAddressPostalCode": "46410-5538",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "219-472-0379",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "07/07/2025",
"LastUpdateDate": "07/07/2025",
"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": "363LF0000X",
"TaxonomyName": "Family Nurse Practitioner",
"LicenseNumber": "28167189A",
"LicenseNumberStateCode": "IN",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}