Pamela Anderson, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

67931-030 Issued in WI

Practice address

11202 79 Street
Pleasant Prairie, WI 53158

Phone

(262) 694-8468

NPI assigned

Nov 20, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195084800000",
    "number": "1932273398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11202 79 STREET",
            "city": "PLEASANT PRAIRIE",
            "state": "WI",
            "postal_code": "53158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11202 79 STREET",
            "city": "PLEASANT PRAIRIE",
            "state": "WI",
            "postal_code": "53158",
            "telephone_number": "262-694-8468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "PAMELA",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2007-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "WI",
            "license": "67831-030",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "67931-030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anika Alam, PA
• MHD Anas Alsawaf, MBBS, MD
• Thomas M Ambro, MD
• Daisy Andaleon, M.D.
• McKenna Anderson, OTR/L
• Anzhela Andreichyk
• Renee Noelle Andrews, MS,RD,CD
• Rachel Elizabeth Cui Antony, PA-C
• Frederick Antwi
• Nida Aqil, DMD

• All providers in Pleasant Prairie, WI
• Registered Nurse in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2007; 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.