Active NPI
Pamela Lee, CDE
- Diabetes Educator Registered Nurse
- Mequon, WI
National Provider Identifier
1063680593
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diabetes Educator Registered Nurse
- License
- 71536
- Practice address
- 12203 Corporate Pkwy
Mequon, WI 53092-3388 - Phone
- (262) 387-8200
- Fax
- (262) 387-8271
- NPI assigned
- Feb 19, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diabetes Educator Registered Nurse | 163WD0400X | 71536 | WI | Primary |
Addresses
Primary practice location
12203 Corporate Pkwy
Mequon, WI 53092-3388
Mailing address
3003 W Good Hope Rd
Milwaukee, WI 53209-2042
Phone (414) 352-3100
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
| License | State | Type | Specialty |
|---|---|---|---|
| 71536 | WI | MD | Diabetes Educator Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1203379200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1293408000000",
"number": "1063680593",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3003 W GOOD HOPE RD",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532092042",
"telephone_number": "414-352-3100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12203 CORPORATE PKWY",
"city": "MEQUON",
"state": "WI",
"postal_code": "530923388",
"telephone_number": "262-387-8200",
"fax_number": "262-387-8271"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "PAMELA",
"credential": "CDE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-02-19",
"last_updated": "2010-12-27",
"status": "A"
},
"taxonomies": [
{
"code": "163WD0400X",
"taxonomy_group": "",
"desc": "Registered Nurse, Diabetes Educator",
"state": "WI",
"license": "71536",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mequon, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.