{
"Npi": {
"NPI": "1669720637",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "WEAVER",
"FirstName": "JACQUELINE",
"MiddleName": "KIMBELL",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "RPH",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "300 MICHAEL TRL",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MINDEN",
"MailingAddressStateName": "LA",
"MailingAddressPostalCode": "71055-7631",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "318-553-7136",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1208 HOMER RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MINDEN",
"PracticeLocationAddressStateName": "LA",
"PracticeLocationAddressPostalCode": "71055-3082",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "318-371-1292",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "08/26/2012",
"LastUpdateDate": "08/26/2012",
"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": "183500000X",
"TaxonomyName": "Pharmacist",
"LicenseNumber": "15301",
"LicenseNumberStateCode": "LA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}