Individual provider Active NPI

Pamela Charlene Prince, N.P.

  • Women's Health Nurse Practitioner
  • Milwaukee, WI
National Provider Identifier
1538202262
Registry record updated Jan 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
72997-030 Issued in WI
Practice address
949 N 9TH St
Health Services Unit
Milwaukee, WI 53233-1422
Phone
(414) 226-7136
Fax
(414) 226-7159
NPI assigned
Feb 14, 2007
Last updated
Jan 29, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 72997-030 WI Primary

Addresses

Primary practice location

949 N 9TH St
Health Services Unit
Milwaukee, WI 53233-1422

Mailing address

4059 N 23Rd St
Milwaukee, WI 53209-6601
Phone (414) 445-7071

Other identifiers 1

IdentifierTypeStateIssuer
12610501OtherWICAQH

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
72997-030WIMDWomen's Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390953600000",
    "number": "1538202262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4059 N 23RD ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532096601",
            "telephone_number": "414-445-7071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "949 N 9TH ST",
            "address_2": "HEALTH SERVICES UNIT",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532331422",
            "telephone_number": "414-226-7136",
            "fax_number": "414-226-7159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRINCE",
        "first_name": "PAMELA",
        "middle_name": "CHARLENE",
        "name_prefix": "Ms.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-14",
        "last_updated": "2014-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "WI",
            "license": "72997-030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12610501",
            "state": "WI"
        }
    ],
    "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 Jan 29, 2014; 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.