Active NPI
Aquilla Robertson
- Registered Nurse
- Milwaukee, WI
National Provider Identifier
1639706617
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 244233
- Practice address
- 5029 N 37TH St
Milwaukee, WI 53209-5331 - Phone
- (414) 865-3285
- NPI assigned
- Mar 27, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 244233 | WI | Primary |
Addresses
Primary practice location
5029 N 37TH St
Milwaukee, WI 53209-5331
Mailing address
5029 N 37TH St
Milwaukee, WI 53209-5331
Phone (414) 865-3285
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000 | 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 |
|---|---|---|---|
| 244233 | WI | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585267200000",
"number": "1639706617",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5029 N 37TH ST",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532095331",
"telephone_number": "414-865-3285"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5029 N 37TH ST",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532095331",
"telephone_number": "414-865-3285"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTSON",
"first_name": "AQUILLA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-03-27",
"last_updated": "2020-03-27",
"certification_date": "2020-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "WI",
"license": "244233",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000000",
"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 Mar 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.