Pamela R Deback, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

440933 Issued in WI

Practice address

2514 S 102ND St Ste 160
West Allis, WI 53227-2142

Phone

(414) 225-0304

NPI assigned

Jun 6, 2011

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1307318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483488000000",
    "number": "1487948626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6860 DALLAS PKWY",
            "address_2": "STE 550",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750244252",
            "telephone_number": "414-688-5751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2514 S 102ND ST STE 160",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532272142",
            "telephone_number": "414-225-0304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBACK",
        "first_name": "PAMELA",
        "middle_name": "R",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-06",
        "last_updated": "2017-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "WI",
            "license": "4409",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "440933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Elyse Davis, OTD, OTR/L
• Michael J Dawson, MD
• Mark Dawydowycz, PA
• Teresa M De la Garza
• Amy M Deal, LPC-IT
• Rita J Debiase
• Sara J Deblaey, RRT
• Cheryl Dedecker, LPC
• Dedrick Home Care Services LLC
• Kayla Deitte

• Nurse Practitioner in West Allis, WI
• Providers in West Allis, WI by specialty
• Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 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.