Individual provider Active NPI

Valerie June Lake, RN

  • Registered Nurse
  • West Allis, WI
National Provider Identifier
1063711844
Registry record updated Mar 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
176928-30 Issued in WI
Practice address
8106A W Lapham St
West Allis, WI 53214-4442
Phone
(414) 520-9069
NPI assigned
Mar 20, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 176928-30 WI Primary

Addresses

Primary practice location

8106A W Lapham St
West Allis, WI 53214-4442

Mailing address

8106A W Lapham St
West Allis, WI 53214-4442
Phone (414) 520-9069

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
176928-30WIMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1300579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300579200000",
    "number": "1063711844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8106A W LAPHAM ST",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532144442",
            "telephone_number": "414-520-9069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8106A W LAPHAM ST",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532144442",
            "telephone_number": "414-520-9069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKE",
        "first_name": "VALERIE",
        "middle_name": "JUNE",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-20",
        "last_updated": "2011-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "176928-30",
            "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 Mar 20, 2011; 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.