{
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"FirstLinePracticeLocationAddress": "1021 EDEN WAY N",
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"EnumerationDate": "09/05/2025",
"LastUpdateDate": "12/18/2025",
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"NPIReactivationDate": null,
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"Gender": null,
"AuthorizedOfficialLastName": "PARKER",
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"AuthorizedOfficialCredential": "PHMNP",
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"Taxonomy": {
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}
},
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}
}
}
}