Carolyn Exum

Primary specialty

Addiction (Substance Use Disorder) Registered NurseTaxonomy code 163WA0400X

License

135848 Issued in WI

Practice address

3707 N Richards St
Milwaukee, WI 53212-1673

Phone

(414) 967-7006

Fax

(414) 967-7020

NPI assigned

Mar 10, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1489104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489104000000",
    "number": "1144761123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4069 N 91ST ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532221605",
            "telephone_number": "414-366-1880",
            "fax_number": "414-967-7020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3707 N RICHARDS ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532121673",
            "telephone_number": "414-967-7006",
            "fax_number": "414-967-7020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EXUM",
        "first_name": "CAROLYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-10",
        "last_updated": "2017-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "135848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Addiction (Substance Use Disorder) Registered Nurse in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Addiction (Substance Use Disorder) Registered Nurse in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2017; 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.