{
"Npi": {
"NPI": "1801550330",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "SKARO",
"FirstName": "NICOLE",
"MiddleName": "ANN",
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": "BA, PEND MPH, CPPS",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "SKARO",
"OtherFirstName": "NICOLE",
"OtherMiddleName": "ANN",
"OtherNamePrefix": "MRS.",
"OtherNameSuffix": null,
"OtherCredential": "BA, PEND MPH, CPPS",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "PO BOX 293",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "WACONIA",
"MailingAddressStateName": "MN",
"MailingAddressPostalCode": "55387-0293",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "952-258-9861",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1683 SAINT GEORGE ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "WACONIA",
"PracticeLocationAddressStateName": "MN",
"PracticeLocationAddressPostalCode": "55387-4549",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "952-258-9861",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "10/30/2021",
"LastUpdateDate": "10/30/2021",
"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": "172V00000X",
"TaxonomyName": "Community Health Worker",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}