Individual provider Active NPI

Jacqusie Lavern Trussell

  • Case Management Registered Nurse
  • Milwaukee, WI
National Provider Identifier
1891476164
Registry record updated Jul 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management Registered NurseTaxonomy code 163WC0400X
License
251B00000X Issued in WI
Practice address
6105 W Sheridan Ave
Milwaukee, WI 53218-3146
Phone
(262) 336-0056
Fax
(262) 336-0065
NPI assigned
Jul 28, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Registered Nurse 163WC0400X 251B00000X WI Primary

Addresses

Primary practice location

6105 W Sheridan Ave
Milwaukee, WI 53218-3146

Mailing address

6105 W Sheridan Ave
Milwaukee, WI 53218-3146
Phone (262) 336-0065

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
251B00000XWIMDCase Management Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1690502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690502400000",
    "number": "1891476164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6105 W SHERIDAN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532183146",
            "telephone_number": "262-336-0065",
            "fax_number": "262-336-0065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6105 W SHERIDAN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532183146",
            "telephone_number": "262-336-0056",
            "fax_number": "262-336-0065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUSSELL",
        "first_name": "JACQUSIE",
        "middle_name": "LAVERN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-28",
        "last_updated": "2023-07-28",
        "certification_date": "2023-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "WI",
            "license": "251B00000X",
            "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 Jul 28, 2023; 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.