Audrie Rose Mouzakis, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

172876-030 Issued in WI

Practice address

1400 Hunters Ridge Dr
Unit 63
Genoa City, WI 53128-2532

Phone

(262) 215-9691

NPI assigned

Aug 29, 2010

Last updated

Aug 29, 2010By the provider in NPPES

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

Other names 1

• Audrie Rose Soble Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1283040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283040000000",
    "number": "1336455294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 HUNTERS RIDGE DR",
            "address_2": "UNIT 63",
            "city": "GENOA CITY",
            "state": "WI",
            "postal_code": "531282532",
            "telephone_number": "262-215-9691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 HUNTERS RIDGE DR",
            "address_2": "UNIT 63",
            "city": "GENOA CITY",
            "state": "WI",
            "postal_code": "531282532",
            "telephone_number": "262-215-9691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUZAKIS",
        "first_name": "AUDRIE",
        "middle_name": "ROSE",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-29",
        "last_updated": "2010-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "172876-030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AUDRIE",
            "last_name": "SOBLE",
            "middle_name": "ROSE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Registered Nurse in Genoa City, WI
• Providers in Genoa City, WI by specialty
• Registered Nurse in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 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.

Verify at the official NPI Registry.