{"npi":"1013756576","type":"NPI-1","status":"active","name":{"display":"Nicole Back","other":[],"first":"NICOLE","last":"BACK","middle":"IRENE"},"specialty":{"primary_taxonomy":"363LF0000X","primary_taxonomy_description":"Family Nurse Practitioner","slug":"family-nurse-practitioner","schema_org_specialty":null,"all":[{"code":"163W00000X","description":"Registered Nurse","primary":false,"state":"MI","license":"4704247636"},{"code":"363LF0000X","description":"Family Nurse Practitioner","primary":true,"state":"MI","license":"4704247636"}]},"addresses":[{"purpose":"LOCATION","street_1":"5758 COOLEY LAKE RD","city":"WATERFORD","state":"MI","postal_code":"483273073","country_code":"US","phone":"8554663631"},{"purpose":"MAILING","street_1":"5758 COOLEY LAKE RD","city":"WATERFORD","state":"MI","postal_code":"483273073","country_code":"US","phone":"8554663631"}],"license":{"state":"MI","number":"4704247636"},"identifiers":[],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20241206002028","type_code":"14-50","type_desc":"PRACTITIONER - NURSE PRACTITIONER","state":"MI","pac_id":"7719413293"}]},"enumeration_date":"2024-05-23","last_updated":"2025-03-06","_meta":{"source":"NPPES","snapshot_date":"2025-03-06","doc_url":"https://findmynpi.com/api"}}