{
"Npi": {
"NPI": "1821348822",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "DOBLING",
"FirstName": "JENNA",
"MiddleName": "LAVIN",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "CRNA",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "STORMO",
"OtherFirstName": "JENNA",
"OtherMiddleName": "LAVIN",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "RN",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "N15W28300 GOLF RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PEWAUKEE",
"MailingAddressStateName": "WI",
"MailingAddressPostalCode": "53072-4800",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "262-303-5055",
"MailingAddressFaxNumber": "262-303-5057",
"FirstLinePracticeLocationAddress": "N15W28300 GOLF RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "PEWAUKEE",
"PracticeLocationAddressStateName": "WI",
"PracticeLocationAddressPostalCode": "53072-4800",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "262-303-5055",
"PracticeLocationAddressFaxNumber": "262-303-5057",
"EnumerationDate": "09/17/2012",
"LastUpdateDate": "10/25/2024",
"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": "148562-30",
"LicenseNumberStateCode": "WI",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "163W00000X",
"TaxonomyName": "Registered Nurse",
"LicenseNumber": "RN2280800",
"LicenseNumberStateCode": "MA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "367500000X",
"TaxonomyName": "Certified Registered Nurse Anesthetist",
"LicenseNumber": "0024171651",
"LicenseNumberStateCode": "VA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "367500000X",
"TaxonomyName": "Certified Registered Nurse Anesthetist",
"LicenseNumber": "14690-33",
"LicenseNumberStateCode": "WI",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}