{"npi":"1629068705","type":"NPI-1","status":"active","name":{"display":"Loretta Bostic CRNA, Pmhnp-Bc","other":[],"first":"LORETTA","last":"BOSTIC","middle":"ANN","credential":"CRNA, PMHNP-BC"},"specialty":{"primary_taxonomy":"363LP0808X","primary_taxonomy_description":"Psychiatric/Mental Health Nurse Practitioner","slug":"psychiatric-mental-health-nurse-practitioner","schema_org_specialty":null,"all":[{"code":"367500000X","description":"Certified Registered Nurse Anesthetist","primary":false,"state":"WV","license":"33849"},{"code":"363LP0808X","description":"Psychiatric/Mental Health Nurse Practitioner","primary":true,"state":"WV","license":"106941"}]},"addresses":[{"purpose":"LOCATION","street_1":"661 LICK BRANCH RD","city":"CHARLESTON","state":"WV","postal_code":"253126761","country_code":"US","phone":"3042080707","fax":"8558514405"},{"purpose":"MAILING","street_1":"661 LICK BRANCH RD","city":"CHARLESTON","state":"WV","postal_code":"253126761","country_code":"US","phone":"3042080707","fax":"8558514405"}],"license":{"state":"WV","number":"106941"},"identifiers":[],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20031204000912","type_code":"14-43","type_desc":"PRACTITIONER - CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)","state":"WV","pac_id":"2466357280"},{"enrlmt_id":"I20140416000573","type_code":"14-43","type_desc":"PRACTITIONER - CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)","state":"SC","pac_id":"2466357280"},{"enrlmt_id":"I20200810000170","type_code":"14-50","type_desc":"PRACTITIONER - NURSE PRACTITIONER","state":"WV","pac_id":"2466357280"}]},"enumeration_date":"2005-10-28","last_updated":"2024-07-23","_meta":{"source":"NPPES","snapshot_date":"2024-07-23","doc_url":"https://findmynpi.com/api"}}