{
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"FirstLineMailingAddress": "625 CLEVELAND AVE NW",
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"MailingAddressCityName": "CANTON",
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"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "304-550-3743",
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"FirstLinePracticeLocationAddress": "2600 SIXTH ST SW FL 6",
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"PracticeLocationAddressTelephoneNumber": "330-830-3393",
"PracticeLocationAddressFaxNumber": "234-521-7091",
"EnumerationDate": "03/30/2017",
"LastUpdateDate": "03/21/2022",
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"GenderCode": "F",
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"Taxonomies": {
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"TaxonomyName": "Licensed Practical Nurse",
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"LicenseNumberStateCode": "OH",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}