Individual provider Active NPI

Mary Ellen Yahle, RN, PMHCNS-BC

  • Adult Psychiatric/Mental Health Clinical Nurse Specialist
  • Milwaukee, WI
National Provider Identifier
1790898294
Registry record updated Aug 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0809X
License
52259-30 Issued in WI
Practice address
2524 E Webster PL
Suite 203
Milwaukee, WI 53211-4253
Phone
(414) 964-9200
Fax
(414) 964-4816
NPI assigned
Aug 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Psychiatric/Mental Health Clinical Nurse Specialist 364SP0809X 52259-30 WI Primary

Addresses

Primary practice location

2524 E Webster PL
Suite 203
Milwaukee, WI 53211-4253

Mailing address

2524 E Webster PL
Suite 203
Milwaukee, WI 53211-4256
Phone (414) 964-9200

Other identifiers 1

IdentifierTypeStateIssuer
39405700MedicaidWI

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)
Enrolled
Credentials
Certified Nurse Specialist, Registered Nurse

State licenses

LicenseStateTypeSpecialty
52259-30WIMDAdult Psychiatric/Mental Health Clinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408492800000",
    "number": "1790898294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2524 E WEBSTER PL",
            "address_2": "SUITE 203",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532114256",
            "telephone_number": "414-964-9200",
            "fax_number": "414-964-4816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2524 E WEBSTER PL",
            "address_2": "SUITE 203",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532114253",
            "telephone_number": "414-964-9200",
            "fax_number": "414-964-4816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAHLE",
        "first_name": "MARY",
        "middle_name": "ELLEN",
        "credential": "RN, PMHCNS-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-17",
        "last_updated": "2014-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "WI",
            "license": "52259-30",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39405700",
            "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 Aug 20, 2014; 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.