{
"Npi": {
"NPI": "1902376312",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "MYRIECKES",
"FirstName": "LATASHA",
"MiddleName": "DEANNE",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "APRN",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1150 LORDS HILL DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "FOUNTAIN",
"MailingAddressStateName": "CO",
"MailingAddressPostalCode": "80817-6601",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "719-322-5460",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "4776 EAGLERIDGE CIR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "PUEBLO",
"PracticeLocationAddressStateName": "CO",
"PracticeLocationAddressPostalCode": "81008-2189",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "719-553-1000",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "11/28/2018",
"LastUpdateDate": "11/28/2018",
"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": "APN0994336NP",
"LicenseNumberStateCode": "CO",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}