{
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"FirstLineMailingAddress": "4218 SUMMER SHADE WAY",
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"MailingAddressCityName": "OWINGS MILLS",
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"FirstLinePracticeLocationAddress": "9861 BROKEN LAND PKWY STE 100",
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"PracticeLocationAddressCityName": "COLUMBIA",
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"PracticeLocationAddressFaxNumber": "410-381-0216",
"EnumerationDate": "05/24/2018",
"LastUpdateDate": "09/11/2025",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "AWODIPE",
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"AuthorizedOfficialCredential": "FNP",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Family Nurse Practitioner",
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"LicenseNumberStateCode": "MD",
"PrimaryTaxonomySwitch": "Y"
}
},
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}
}
}
}