Nicole D Emlen, APNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

7826 Issued in WI

Practice address

9000 W Wisconsin Ave
Milwaukee, WI 53226-4874

Phone

(414) 337-7050

Fax

(414) 337-7020

NPI assigned

Aug 22, 2017

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Nicole D Stark Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: nemlen5199@direct.chw.org

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

{
    "created_epoch": "1503360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1407372378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 W WISCONSIN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264874",
            "telephone_number": "414-337-7050",
            "fax_number": "414-337-7020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 W WISCONSIN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264874",
            "telephone_number": "414-337-7050",
            "fax_number": "414-337-7020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMLEN",
        "first_name": "NICOLE",
        "middle_name": "D",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-22",
        "last_updated": "2022-07-21",
        "certification_date": "2020-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "7826-33",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "WI",
            "license": "7826",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1407372378",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "STARK",
            "middle_name": "D",
            "credential": "APNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Pediatric Nurse Practitioner in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Pediatric Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.