{"npi":"1912419243","type":"NPI-1","status":"active","name":{"display":"Mrs. Lisa Henderson Agnp-C","other":[],"first":"LISA","last":"HENDERSON","middle":"RENEE","credential":"AGNP-C"},"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":"ID","license":"57109"}]},"addresses":[{"purpose":"LOCATION","street_1":"415 SIXTH ST.","city":"LEWISTON","state":"ID","postal_code":"835014255","country_code":"US","street_2":"CARDIOLOGY DEPARTMENT","phone":"2087507507","fax":"2087507384"},{"purpose":"MAILING","street_1":"415 6TH ST","city":"LEWISTON","state":"ID","postal_code":"835012431","country_code":"US","phone":"2087507445"}],"license":{"state":"ID","number":"57109"},"identifiers":[],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20180214001278","type_code":"14-50","type_desc":"PRACTITIONER - NURSE PRACTITIONER","state":"ID","pac_id":"3870853724"},{"enrlmt_id":"I20230619001482","type_code":"14-50","type_desc":"PRACTITIONER - NURSE PRACTITIONER","state":"WA","pac_id":"3870853724"}]},"enumeration_date":"2017-10-26","last_updated":"2019-11-14","_meta":{"source":"NPPES","snapshot_date":"2019-11-14","doc_url":"https://findmynpi.com/api"}}