{
"Npi": {
"NPI": "1790585354",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "WILEY",
"FirstName": "AMANDA",
"MiddleName": "KAY",
"NamePrefix": "MISS",
"NameSuffix": null,
"Credential": "RN",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "107 STONEBROOK DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HURRICANE",
"MailingAddressStateName": "WV",
"MailingAddressPostalCode": "25526-8822",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "304-972-3141",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "300 CORPORATE CENTER DRIVE",
"SecondLinePracticeLocationAddress": "ATTN: CARDIOLOGY",
"PracticeLocationAddressCityName": "SCOTT DEPOT",
"PracticeLocationAddressStateName": "WV",
"PracticeLocationAddressPostalCode": "25560",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "304-691-6732",
"PracticeLocationAddressFaxNumber": "304-691-6919",
"EnumerationDate": "03/13/2025",
"LastUpdateDate": "01/02/2026",
"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": "163W00000X",
"TaxonomyName": "Registered Nurse",
"LicenseNumber": "121532",
"LicenseNumberStateCode": "WV",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}