{
"Npi": {
"NPI": "1902215460",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "DUBERVILLE",
"FirstName": "JEFFRIE",
"MiddleName": "LYN",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "FNP-BC",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "DUBERVILLE",
"OtherFirstName": "JEFFRIE",
"OtherMiddleName": "PERKINS",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "FNP-BC",
"OtherLastNameTypeCode": "5",
"FirstLineMailingAddress": "1765 LAWTON DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SULPHUR",
"MailingAddressStateName": "LA",
"MailingAddressPostalCode": "70665-8611",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "337-764-4628",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1765 LAWTON DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SULPHUR",
"PracticeLocationAddressStateName": "LA",
"PracticeLocationAddressPostalCode": "70665-8611",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "337-764-4628",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "08/10/2014",
"LastUpdateDate": "09/12/2015",
"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": "AP07974",
"LicenseNumberStateCode": "LA",
"PrimaryTaxonomySwitch": "Y"
},
{
"TaxonomyCode": "363LF0000X",
"TaxonomyName": "Family Nurse Practitioner",
"LicenseNumber": "128195",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "363LF0000X",
"TaxonomyName": "Family Nurse Practitioner",
"LicenseNumber": "02736",
"LicenseNumberStateCode": "NM",
"PrimaryTaxonomySwitch": "N"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}