{
"Npi": {
"NPI": "1689289357",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "NEUFELD",
"FirstName": "KATELYN",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": "NP",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "HAGEN",
"OtherFirstName": "KATELYN",
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "463 TREMONT ST W",
"SecondLineMailingAddress": "STE 200",
"MailingAddressCityName": "PORT ORCHARD",
"MailingAddressStateName": "WA",
"MailingAddressPostalCode": "98366-3743",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "360-876-2434",
"MailingAddressFaxNumber": "360-876-2696",
"FirstLinePracticeLocationAddress": "463 TREMONT ST W",
"SecondLinePracticeLocationAddress": "STE 200",
"PracticeLocationAddressCityName": "PORT ORCHARD",
"PracticeLocationAddressStateName": "WA",
"PracticeLocationAddressPostalCode": "98366-3743",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "360-876-2434",
"PracticeLocationAddressFaxNumber": "360-876-2696",
"EnumerationDate": "09/10/2020",
"LastUpdateDate": "05/29/2024",
"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": "AP61091733",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}