{
"Npi": {
"NPI": "1669884870",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "HINES",
"FirstName": "STEPHANIE",
"MiddleName": "MARIE",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "PHARMD",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "8715 W HIGHWAY 71 APT 5207",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "AUSTIN",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "78735-0037",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "520-331-1723",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1137 S DOBSON RD # 10",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MESA",
"PracticeLocationAddressStateName": "AZ",
"PracticeLocationAddressPostalCode": "85202-3902",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "480-964-1411",
"PracticeLocationAddressFaxNumber": "480-610-8152",
"EnumerationDate": "05/21/2014",
"LastUpdateDate": "03/03/2023",
"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": "S019243",
"LicenseNumberStateCode": "AZ",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "183500000X",
"TaxonomyName": "Pharmacist",
"LicenseNumber": "72086",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}