Carolyn Brown, LPN

Key facts

NPI

1942500384

Entity type

Individual (NPI type 1)

Primary specialty

Licensed Practical Nurse 164W00000X

License

304703-031 (WI)

Practice address

4619 W. Woodale Ave
Brown Deer, WI 53223

Phone

(414) 803-6756

Fax

(414) 371-9767

NPI assigned

Nov 2, 2010

Sex

Female

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 2, 2010.

{
    "created_epoch": "1288656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288656000000",
    "number": "1942500384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4619 W. WOODALE AVE",
            "city": "BROWN DEER",
            "state": "WI",
            "postal_code": "53223",
            "telephone_number": "414-803-6756",
            "fax_number": "414-371-9767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4619 W. WOODALE AVE",
            "city": "BROWN DEER",
            "state": "WI",
            "postal_code": "53223",
            "telephone_number": "414-803-6756",
            "fax_number": "414-371-9767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "CAROLYN",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-02",
        "last_updated": "2010-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WI",
            "license": "304703-031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Brown Deer, WI · Licensed Practical Nurse in Wisconsin