{"npi":"1669925673","type":"NPI-1","status":"active","name":{"display":"Mrs. Gillian Wenzke Ag-Acnp","other":[{"code":"1","type":"Formerly known as","value":"DIEDERICH, GILLIAN MARGARET"}],"first":"GILLIAN","last":"WENZKE","middle":"DIEDERICH","credential":"AG-ACNP"},"specialty":{"primary_taxonomy":"363L00000X","primary_taxonomy_description":"Nurse Practitioner","slug":"nurse-practitioner","schema_org_specialty":null,"all":[{"code":"363L00000X","description":"Nurse Practitioner","primary":true,"state":"OH","license":"CNP.019493"}]},"addresses":[{"purpose":"LOCATION","street_1":"500 LINCOLN PARK BLVD","city":"DAYTON","state":"OH","postal_code":"454293492","country_code":"US","street_2":"SUITE 100","phone":"9372223118","fax":"9372221436"},{"purpose":"MAILING","street_1":"500 LINCOLN PARK BLVD","city":"DAYTON","state":"OH","postal_code":"454293492","country_code":"US","street_2":"SUITE 100","phone":"9372223118","fax":"9372221436"}],"license":{"state":"OH","number":"CNP.019493"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"PENDING","state":"OH","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20160919002179","type_code":"14-50","type_desc":"PRACTITIONER - NURSE PRACTITIONER","state":"OH","pac_id":"3678860673"}]},"enumeration_date":"2016-07-26","last_updated":"2024-11-08","_meta":{"source":"NPPES","snapshot_date":"2024-11-08","doc_url":"https://findmynpi.com/api"}}