{
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"EIN": null,
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"Credential": "FNP-C",
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"OtherLastName": "TOVAR",
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"FirstLineMailingAddress": "645 E MISSOURI AVE STE 280",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PHOENIX",
"MailingAddressStateName": "AZ",
"MailingAddressPostalCode": "85012-1349",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "602-264-9100",
"MailingAddressFaxNumber": "602-264-9101",
"FirstLinePracticeLocationAddress": "15215 S 48TH ST STE 161",
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"PracticeLocationAddressCityName": "PHOENIX",
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"PracticeLocationAddressPostalCode": "85044-9139",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "602-633-4493",
"PracticeLocationAddressFaxNumber": "602-716-9656",
"EnumerationDate": "05/22/2017",
"LastUpdateDate": "09/20/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Family Nurse Practitioner",
"LicenseNumber": "AP10008",
"LicenseNumberStateCode": "AZ",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}