Active NPI
Laura Palmer, APNP
- Pediatric Nurse Practitioner
- New Berlin, WI
National Provider Identifier
1639685274
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 8171-33
- Practice address
- 4855 S Moorland Rd # Rod
New Berlin, WI 53151-7494 - Phone
- (262) 432-7599
- NPI assigned
- Dec 19, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 8171-33 | WI | Primary |
Addresses
Primary practice location
4855 S Moorland Rd # Rod
New Berlin, WI 53151-7494
Mailing address
5558 N Iroquois Ave
Glendale, WI 53217-5014
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639685274 | Medicaid | WI |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8171-33 | WI | MD | Pediatric Nurse Practitioner |
Interoperability endpoints
- lpalmer30848@direct.chw.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1513641600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1513814400000",
"number": "1639685274",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5558 N IROQUOIS AVE",
"city": "GLENDALE",
"state": "WI",
"postal_code": "532175014"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4855 S MOORLAND RD # ROD",
"city": "NEW BERLIN",
"state": "WI",
"postal_code": "531517494",
"telephone_number": "262-432-7599"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PALMER",
"first_name": "LAURA",
"credential": "APNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-12-19",
"last_updated": "2017-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "WI",
"license": "8171-33",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1639685274",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in New Berlin, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 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.