{
"Npi": {
"NPI": "1710528914",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "WILLIAMS",
"FirstName": "CRYSTAL",
"MiddleName": "CHE",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "DNP",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "HARRIS",
"OtherFirstName": "CRYSTAL",
"OtherMiddleName": "CHE",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "307 AIKEN TER",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ABINGDON",
"MailingAddressStateName": "MD",
"MailingAddressPostalCode": "21009-2003",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "352-219-3405",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "711 W 40TH ST STE 173",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BALTIMORE",
"PracticeLocationAddressStateName": "MD",
"PracticeLocationAddressPostalCode": "21211-2147",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "443-961-1221",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "09/30/2019",
"LastUpdateDate": "03/17/2025",
"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": "363LF0000X",
"TaxonomyName": "Family Nurse Practitioner",
"LicenseNumber": "AP61005850",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "363LF0000X",
"TaxonomyName": "Family Nurse Practitioner",
"LicenseNumber": "R207896",
"LicenseNumberStateCode": "MD",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}