NameDescriptionTypeAdditional information
FirstName

string

Required
LastName

string

Required
Sln

string

None.
SlnStateID

string

None.
Dea

string

None.
DeaStateId

string

None.
Email

string

None.
PhoneNumber

string

Required
AddressName

string

Required
Address1

string

Required
Address2

string

None.
City

string

Required
State

string

Required
PostalCode

string

Required
PartnerPrescriberId

string

Required
AltPartnerPrescriberId

string

None.