{"npi":"1417455809","type":"NPI-1","status":"active","name":{"display":"Andrea Wallace FNP","other":[],"first":"ANDREA","last":"WALLACE","middle":"NICOLE","credential":"FNP"},"specialty":{"primary_taxonomy":"363LF0000X","primary_taxonomy_description":"Family Nurse Practitioner","slug":"family-nurse-practitioner","schema_org_specialty":null,"all":[{"code":"363L00000X","description":"Nurse Practitioner","primary":false,"state":"NC","license":"5010264"},{"code":"363LF0000X","description":"Family Nurse Practitioner","primary":true,"state":"NC","license":"5010264"}]},"addresses":[{"purpose":"LOCATION","street_1":"14214 BALLANTYNE LAKE RD","city":"CHARLOTTE","state":"NC","postal_code":"282773372","country_code":"US","street_2":"STE 100","phone":"7046672650"},{"purpose":"MAILING","street_1":"PO BOX 19305","city":"CHARLOTTE","state":"NC","postal_code":"282199305","country_code":"US"}],"license":{"state":"NC","number":"5010264"},"identifiers":[],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20180329000098","type_code":"14-50","type_desc":"PRACTITIONER - NURSE PRACTITIONER","state":"NC","pac_id":"8729340849"}]},"enumeration_date":"2018-01-31","last_updated":"2024-07-15","_meta":{"source":"NPPES","snapshot_date":"2024-07-15","doc_url":"https://findmynpi.com/api"}}