Individual provider Active NPI

Diane Melrose, MSN, RN, AGCNS-BC

  • Adult Health Clinical Nurse Specialist
  • Milwaukee, WI
National Provider Identifier
1396391629
Registry record updated Aug 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Clinical Nurse SpecialistTaxonomy code 364SA2200X
License
174823 Issued in WI
Practice address
2900 W Oklahoma Ave
Milwaukee, WI 53215-4330
Phone
(414) 646-6000
NPI assigned
Aug 13, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Clinical Nurse Specialist 364SA2200X 174823 WI Primary

Addresses

Primary practice location

2900 W Oklahoma Ave
Milwaukee, WI 53215-4330

Mailing address

N99W16182 Northway
Germantown, WI 53022-5026

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
Master of Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
174823WIMDAdult Health Clinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1565654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565654400000",
    "number": "1396391629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N99W16182 NORTHWAY",
            "city": "GERMANTOWN",
            "state": "WI",
            "postal_code": "530225026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 W OKLAHOMA AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532154330",
            "telephone_number": "414-646-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELROSE",
        "first_name": "DIANE",
        "credential": "MSN, RN, AGCNS-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-13",
        "last_updated": "2019-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "WI",
            "license": "174823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2019; 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.