{
"Npi": {
"NPI": "1902742141",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "HARRELSON",
"FirstName": "KATHLEEN",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": "CNM, WHNP-BC, MSN",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "HARRELSON",
"OtherFirstName": "KATIE",
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "5",
"FirstLineMailingAddress": "10313 DERBY DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LAUREL",
"MailingAddressStateName": "MD",
"MailingAddressPostalCode": "20723-5702",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "2296 OPITZ BLVD STE 440",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "WOODBRIDGE",
"PracticeLocationAddressStateName": "VA",
"PracticeLocationAddressPostalCode": "22191-3355",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "703-878-0740",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "04/28/2026",
"LastUpdateDate": "04/28/2026",
"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": "363LW0102X",
"TaxonomyName": "Women's Health Nurse Practitioner",
"LicenseNumber": "0024196842",
"LicenseNumberStateCode": "VA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "367A00000X",
"TaxonomyName": "Advanced Practice Midwife",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}