{
"Npi": {
"NPI": "1700956703",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "GIBIAN",
"FirstName": "JEANNE",
"MiddleName": "M.",
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": "RN, CPNP",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 10880",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PRESCOTT",
"MailingAddressStateName": "AZ",
"MailingAddressPostalCode": "86304-0880",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "602-406-4786",
"MailingAddressFaxNumber": "916-636-4358",
"FirstLinePracticeLocationAddress": "2120 CENTERPOINTE WEST DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "PRESCOTT",
"PracticeLocationAddressStateName": "AZ",
"PracticeLocationAddressPostalCode": "86301-8487",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "928-778-4581",
"PracticeLocationAddressFaxNumber": "928-776-1872",
"EnumerationDate": "11/08/2006",
"LastUpdateDate": "02/17/2025",
"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": "163WP0200X",
"TaxonomyName": "Pediatric Registered Nurse",
"LicenseNumber": "RN14260",
"LicenseNumberStateCode": "AZ",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "363LP0200X",
"TaxonomyName": "Pediatric Nurse Practitioner",
"LicenseNumber": "AP1307",
"LicenseNumberStateCode": "AZ",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}