Active NPI
Kristine Lee, RA
- Nurse's Aide
- Whitehall, WI
National Provider Identifier
1114070091
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse's Aide
- License
- 113896
- Practice address
- W20298 State Road 121
Whitehall, WI 54773-9685 - Phone
- (715) 538-4518
- Fax
- (715) 538-4535
- NPI assigned
- Jan 22, 2007
- 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 |
|---|---|---|---|---|
| Nurse's Aide | 376K00000X | 113896 | WI | Primary |
Addresses
Primary practice location
W20298 State Road 121
Whitehall, WI 54773-9685
Mailing address
W20298 State Road 121
Whitehall, WI 54773-9685
Phone (715) 538-4518
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 113896 | Other | WI | LICENSE |
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 |
|---|---|---|---|
| 113896 | WI | MD | Nurse's Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1114070091",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "W20298 STATE ROAD 121",
"city": "WHITEHALL",
"state": "WI",
"postal_code": "547739685",
"telephone_number": "715-538-4518",
"fax_number": "715-538-4535"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "W20298 STATE ROAD 121",
"city": "WHITEHALL",
"state": "WI",
"postal_code": "547739685",
"telephone_number": "715-538-4518",
"fax_number": "715-538-4535"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "KRISTINE",
"credential": "RA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "376K00000X",
"taxonomy_group": "",
"desc": "Nurse's Aide",
"state": "WI",
"license": "113896",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "113896",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Whitehall, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.