{
"Npi": {
"NPI": "1962921510",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "KANOPSIC",
"FirstName": "ANNA",
"MiddleName": "PAGE",
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": "APRN",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "FULENWIDER",
"OtherFirstName": "ANNA",
"OtherMiddleName": "PAGE",
"OtherNamePrefix": "MISS",
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "535 N 12TH ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "GRAND JUNCTION",
"MailingAddressStateName": "CO",
"MailingAddressPostalCode": "81501-3323",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "2635 N 7TH ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "GRAND JUNCTION",
"PracticeLocationAddressStateName": "CO",
"PracticeLocationAddressPostalCode": "81501-8209",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "970-298-2273",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "09/14/2017",
"LastUpdateDate": "09/14/2017",
"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": "363L00000X",
"TaxonomyName": "Nurse Practitioner",
"LicenseNumber": "C-APN.0000780-C-NP",
"LicenseNumberStateCode": "CO",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}