{
"Npi": {
"NPI": "1760209340",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "BOHON",
"FirstName": "LISA",
"MiddleName": "GAIL",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "PMHNP-BC",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "BOHON",
"OtherFirstName": "LISA",
"OtherMiddleName": "GAIL",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "APRN",
"OtherLastNameTypeCode": "5",
"FirstLineMailingAddress": "2818 E 45TH CT N",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "WICHITA",
"MailingAddressStateName": "KS",
"MailingAddressPostalCode": "67219-2021",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "316-667-6700",
"MailingAddressFaxNumber": "316-667-6701",
"FirstLinePracticeLocationAddress": "3460 N RIDGE RD STE 120",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "WICHITA",
"PracticeLocationAddressStateName": "KS",
"PracticeLocationAddressPostalCode": "67205-1223",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "316-272-0800",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "09/24/2024",
"LastUpdateDate": "09/08/2025",
"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": "363LP0808X",
"TaxonomyName": "Psychiatric/Mental Health Nurse Practitioner",
"LicenseNumber": "53-83594-072",
"LicenseNumberStateCode": "KS",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}