{
"Npi": {
"NPI": "1871419929",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "MULANAX",
"FirstName": "SUSAN",
"MiddleName": "RIVERS",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "AGACNP-BC",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "RIVERS",
"OtherFirstName": "SUSAN",
"OtherMiddleName": "E",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "AGACNP-BC",
"OtherLastNameTypeCode": "5",
"FirstLineMailingAddress": "607 TULIP CT",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "NOBLESVILLE",
"MailingAddressStateName": "IN",
"MailingAddressPostalCode": "46062-9161",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "317-430-6285",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1701 N SENATE BLVD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "INDIANAPOLIS",
"PracticeLocationAddressStateName": "IN",
"PracticeLocationAddressPostalCode": "46202-1239",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "317-944-7874",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "06/24/2026",
"LastUpdateDate": "06/29/2026",
"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": "390200000X",
"TaxonomyName": "Student in an Organized Health Care Education/Training Program",
"LicenseNumber": null,
"LicenseNumberStateCode": "IN",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "363LA2100X",
"TaxonomyName": "Acute Care Nurse Practitioner",
"LicenseNumber": "71018330A",
"LicenseNumberStateCode": "IN",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}