Individual provider Active NPI

Angela Fay Lacelle Burns, RN

  • Registered Nurse
  • Milwaukee, WI
National Provider Identifier
1689802639
Registry record updated Jun 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
138651-030 Issued in WI
Practice address
8000 W Custer Ave
Milwaukee, WI 53218-3530
Phone
(414) 535-8980
Fax
(424) 535-8909
NPI assigned
Jun 29, 2009
Last updated
Jun 29, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 138651-030 WI Primary

Addresses

Primary practice location

8000 W Custer Ave
Milwaukee, WI 53218-3530

Mailing address

8000 W Custer Ave
Milwaukee, WI 53218-3530
Phone (414) 535-8980

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
138651-030WIMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1246233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246233600000",
    "number": "1689802639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8000 W CUSTER AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532183530",
            "telephone_number": "414-535-8980",
            "fax_number": "424-535-8909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8000 W CUSTER AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532183530",
            "telephone_number": "414-535-8980",
            "fax_number": "424-535-8909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNS",
        "first_name": "ANGELA",
        "middle_name": "FAY LACELLE",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-29",
        "last_updated": "2009-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "138651-030",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jun 29, 2009; 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.