{
"Npi": {
"NPI": "1093871220",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "HUTZLER",
"FirstName": "THERESA",
"MiddleName": "L.",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "APRN, AGACNP",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "CORBIN",
"OtherFirstName": "THERESA",
"OtherMiddleName": "L.",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "200 1ST ST SW",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ROCHESTER",
"MailingAddressStateName": "MN",
"MailingAddressPostalCode": "55905-0002",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "715-838-5222",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1400 BELLINGER ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "EAU CLAIRE",
"PracticeLocationAddressStateName": "WI",
"PracticeLocationAddressPostalCode": "54703-5222",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "715-838-5222",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "12/30/2006",
"LastUpdateDate": "02/16/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "163W00000X",
"TaxonomyName": "Registered Nurse",
"LicenseNumber": "146779-030",
"LicenseNumberStateCode": "WI",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "163WH0200X",
"TaxonomyName": "Home Health Registered Nurse",
"LicenseNumber": "146779-030",
"LicenseNumberStateCode": "WI",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "363LG0600X",
"TaxonomyName": "Gerontology Nurse Practitioner",
"LicenseNumber": "6128-33",
"LicenseNumberStateCode": "WI",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "363L00000X",
"TaxonomyName": "Nurse Practitioner",
"LicenseNumber": "6128",
"LicenseNumberStateCode": "WI",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}