Individual provider Active NPI

Sherryl Lynn Boivin

  • Registered Nurse
  • Milwaukee, WI
National Provider Identifier
1790112282
Registry record updated Sep 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
172936-030 Issued in WI
Practice address
1913 W Kimberly Ave
Milwaukee, WI 53221-5025
Phone
(414) 217-3898
NPI assigned
Sep 30, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2013

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 172936-030 WI Primary

Addresses

Primary practice location

1913 W Kimberly Ave
Milwaukee, WI 53221-5025

Mailing address

1913 W Kimberly Ave
Milwaukee, WI 53221-5025
Phone (414) 217-3898

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
172936-030WIMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1380499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380499200000",
    "number": "1790112282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1913 W KIMBERLY AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532215025",
            "telephone_number": "414-217-3898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1913 W KIMBERLY AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532215025",
            "telephone_number": "414-217-3898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOIVIN",
        "first_name": "SHERRYL",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-30",
        "last_updated": "2013-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "172936-030",
            "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 Sep 30, 2013; 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.