Jacqueline Marie Wallenkamp, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

2886-031 Issued in WI

Practice address

5151 W Silver Spring Dr
Milwaukee, WI 53218-3300

Phone

(414) 527-6940

NPI assigned

Jun 21, 2007

Sex

Female

Sole proprietor

No

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": "1182384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164628848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6107 W WELLS ST",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532133245",
            "telephone_number": "414-476-3844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5151 W SILVER SPRING DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532183300",
            "telephone_number": "414-527-6940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLENKAMP",
        "first_name": "JACQUELINE",
        "middle_name": "MARIE",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WI",
            "license": "2886-031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Prestyne S. Wallace
• Raymond B Wallace, D.O.
• Renae Wallace
• Stephanie Wallace
• Veronica Wallace
• Michael Waller
• Christine M Wallis, MS, RN, ACNS-BC
• Michael Leo Wallner, M.S., LPC, NCC
• Cathy Walls, PT
• La'Tonya Renae Walls, PHD

• Licensed Practical Nurse in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Licensed Practical Nurse in Wisconsin

• 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.

Verify at the official NPI Registry.