{
"Npi": {
"NPI": "1285704858",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "CORBY",
"FirstName": "TRACI",
"MiddleName": "ANN",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "ARNP",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "6150 OAK TREE BLVD",
"SecondLineMailingAddress": "STE 200",
"MailingAddressCityName": "INDEPENDENCE",
"MailingAddressStateName": "OH",
"MailingAddressPostalCode": "44131-2569",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "239-275-8118",
"MailingAddressFaxNumber": "239-275-5914",
"FirstLinePracticeLocationAddress": "12611 WORLD PLAZA LN BLDG 53",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "FORT MYERS",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "33907-3990",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "239-275-8118",
"PracticeLocationAddressFaxNumber": "239-275-5914",
"EnumerationDate": "11/09/2006",
"LastUpdateDate": "07/21/2022",
"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": "363LW0102X",
"TaxonomyName": "Women's Health Nurse Practitioner",
"LicenseNumber": "3165972",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}