{
"Npi": {
"NPI": "1760763825",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "PUETZ",
"FirstName": "CARRIE",
"MiddleName": "NADINE",
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": "NP-C",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "2000 BAYBERRY CT",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SIOUX CITY",
"MailingAddressStateName": "IA",
"MailingAddressPostalCode": "51104-1767",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "712-253-6088",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "380 W ANCHOR DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "NORTH SIOUX CITY",
"PracticeLocationAddressStateName": "SD",
"PracticeLocationAddressPostalCode": "57049-5273",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "605-360-5043",
"PracticeLocationAddressFaxNumber": "612-725-1246",
"EnumerationDate": "09/02/2011",
"LastUpdateDate": "08/19/2022",
"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": "363LF0000X",
"TaxonomyName": "Family Nurse Practitioner",
"LicenseNumber": "A--112847",
"LicenseNumberStateCode": "IA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}