{
"Npi": {
"NPI": "1912663758",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "OVERSTREET",
"FirstName": "CARI",
"MiddleName": "ANN",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "APRN",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "LONG",
"OtherFirstName": "CARI",
"OtherMiddleName": "ANN",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "APRN",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "1836 MATT LN",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HENSLEY",
"MailingAddressStateName": "AR",
"MailingAddressPostalCode": "72065-9278",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "501-749-9978",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "3111 S 70TH ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "FORT SMITH",
"PracticeLocationAddressStateName": "AR",
"PracticeLocationAddressPostalCode": "72903-5017",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "479-452-6650",
"PracticeLocationAddressFaxNumber": "479-452-5847",
"EnumerationDate": "11/16/2021",
"LastUpdateDate": "05/21/2024",
"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": "363LP0808X",
"TaxonomyName": "Psychiatric/Mental Health Nurse Practitioner",
"LicenseNumber": "217960",
"LicenseNumberStateCode": "AR",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "363LP0808X",
"TaxonomyName": "Psychiatric/Mental Health Nurse Practitioner",
"LicenseNumber": "1912663758",
"LicenseNumberStateCode": "AR",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}