{
"Npi": {
"NPI": "1740524875",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "GUNNOE",
"FirstName": "ERICA",
"MiddleName": "DIANE",
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": "FNP-BC",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "CRAWFORD",
"OtherFirstName": "ERICA",
"OtherMiddleName": "DIANE",
"OtherNamePrefix": "MISS",
"OtherNameSuffix": null,
"OtherCredential": "BSN",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "12576 WINFIELD RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "WINFIELD",
"MailingAddressStateName": "WV",
"MailingAddressPostalCode": "25213-7315",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "304-586-0111",
"MailingAddressFaxNumber": "304-586-0114",
"FirstLinePracticeLocationAddress": "2014 HUBER RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "CHARLESTON",
"PracticeLocationAddressStateName": "WV",
"PracticeLocationAddressPostalCode": "25314-2236",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "304-552-4534",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "11/15/2012",
"LastUpdateDate": "09/19/2023",
"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": "APRN70226-FNP-BC",
"LicenseNumberStateCode": "WV",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "363LP0808X",
"TaxonomyName": "Psychiatric/Mental Health Nurse Practitioner",
"LicenseNumber": "APRN70226",
"LicenseNumberStateCode": "WV",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}