{
"Npi": {
"NPI": "1851420582",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "BEHRENS",
"FirstName": "MARY",
"MiddleName": "LYNN",
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": "MS RN FNP C",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "5504 E 22ND ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CASPER",
"MailingAddressStateName": "WY",
"MailingAddressPostalCode": "82609",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "307-577-5023",
"MailingAddressFaxNumber": "307-234-3283",
"FirstLinePracticeLocationAddress": "1915 OXFORD LANE",
"SecondLinePracticeLocationAddress": "WESTSIDE WOMANS CLINIC",
"PracticeLocationAddressCityName": "CASPER",
"PracticeLocationAddressStateName": "WY",
"PracticeLocationAddressPostalCode": "82604",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "307-265-5400",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "03/06/2007",
"LastUpdateDate": "07/08/2007",
"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": "363LF0000X",
"TaxonomyName": "Family Nurse Practitioner",
"LicenseNumber": "78600214",
"LicenseNumberStateCode": "WY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}