Individual provider Active NPI

Audrey Marie Guard, 30247

  • Licensed Practical Nurse
  • Milwaukee, WI
National Provider Identifier
1932540697
Registry record updated Jul 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
30247 Issued in WI
Practice address
2020 W Atkinson Ave
Milwaukee, WI 53209-6872
Phone
(414) 544-8104
NPI assigned
Jul 10, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2013

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 30247 WI Primary

Addresses

Primary practice location

2020 W Atkinson Ave
Milwaukee, WI 53209-6872

Mailing address

2020 W Atkinson Ave
Milwaukee, WI 53209-6872
Phone (414) 544-8104

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
30247WIMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1373414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373414400000",
    "number": "1932540697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 W ATKINSON AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532096872",
            "telephone_number": "414-544-8104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 W ATKINSON AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532096872",
            "telephone_number": "414-544-8104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUARD",
        "first_name": "AUDREY",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "30247",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-10",
        "last_updated": "2013-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WI",
            "license": "30247",
            "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 10, 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.