Individual provider Active NPI

Nikia Coburn, LPN

  • Licensed Practical Nurse
  • Mount Pleasant, WI
National Provider Identifier
1730573262
Registry record updated Mar 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
31-318586 Issued in WI
Practice address
5735 Durand Ave
Suite a
Mount Pleasant, WI 53406-5011
Phone
(262) 549-6698
NPI assigned
Mar 23, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 31-318586 WI Primary

Addresses

Primary practice location

5735 Durand Ave
Suite a
Mount Pleasant, WI 53406-5011

Mailing address

5735 Durand Ave
Suite a
Mount Pleasant, WI 53406-5011
Phone (262) 549-6698

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

LicenseStateTypeSpecialty
31-318586WIMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1427068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427068800000",
    "number": "1730573262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5735 DURAND AVE",
            "address_2": "SUITE A",
            "city": "MOUNT PLEASANT",
            "state": "WI",
            "postal_code": "534065011",
            "telephone_number": "262-549-6698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5735 DURAND AVE",
            "address_2": "SUITE A",
            "city": "MOUNT PLEASANT",
            "state": "WI",
            "postal_code": "534065011",
            "telephone_number": "262-549-6698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COBURN",
        "first_name": "NIKIA",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-23",
        "last_updated": "2015-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WI",
            "license": "31-318586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Pleasant, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2015; 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.