Individual provider Active NPI

Elizabeth Diane Nelson, LPN

  • Licensed Vocational Nurse
  • West Allis, WI
National Provider Identifier
1053544304
Registry record updated Sep 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
304156-031 Issued in WI
Practice address
924 S 74TH St
West Allis, WI 53214-3003
Phone
(608) 317-4663
NPI assigned
Sep 2, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 304156-031 WI Primary

Addresses

Primary practice location

924 S 74TH St
West Allis, WI 53214-3003

Mailing address

924 S 74TH Street
West Allis, WI 53214
Phone (608) 317-4663

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
304156-031WIMDLicensed Vocational Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1251849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251849600000",
    "number": "1053544304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "924 S 74TH STREET",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "53214",
            "telephone_number": "608-317-4663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "924 S 74TH ST",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532143003",
            "telephone_number": "608-317-4663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "ELIZABETH",
        "middle_name": "DIANE",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-02",
        "last_updated": "2009-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "WI",
            "license": "304156-031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Allis, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.