{
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "HENDERSON BIRTH AND WELLNESS, PLLC",
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"NamePrefix": null,
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"FirstLineMailingAddress": "319 8TH ST STE C",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HENDERSON",
"MailingAddressStateName": "KY",
"MailingAddressPostalCode": "42420-2963",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "270-830-3056",
"MailingAddressFaxNumber": "270-830-3058",
"FirstLinePracticeLocationAddress": "319 8TH ST STE C",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "HENDERSON",
"PracticeLocationAddressStateName": "KY",
"PracticeLocationAddressPostalCode": "42420-2963",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "270-830-3056",
"PracticeLocationAddressFaxNumber": "270-830-3058",
"EnumerationDate": "06/11/2022",
"LastUpdateDate": "11/12/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DURHAM",
"AuthorizedOfficialFirstName": "ASHLEY",
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"AuthorizedOfficialTitle": "OWNER/PROVIDER",
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"AuthorizedOfficialCredential": "APRN, CNM, FNP",
"AuthorizedOfficialTelephoneNumber": "270-577-9333",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}