Lane Ellen Poulin, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

32436031 Issued in WI

Practice address

44045 Wheatville Road
Gays Mills, WI 54631

Phone

(608) 872-2156

NPI assigned

Apr 2, 2008

Last updated

Apr 2, 2008By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1207094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207094400000",
    "number": "1962674689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44045 WHEATVILLE ROAD",
            "city": "GAYS MILLS",
            "state": "WI",
            "postal_code": "54631",
            "telephone_number": "608-872-2156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44045 WHEATVILLE ROAD",
            "city": "GAYS MILLS",
            "state": "WI",
            "postal_code": "54631",
            "telephone_number": "608-872-2156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POULIN",
        "first_name": "LANE",
        "middle_name": "ELLEN",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-02",
        "last_updated": "2008-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WI",
            "license": "32436031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "35053100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Margaret Mary Havllik
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• Ellen Pestcoe, OTR
• Judy Powell
• Richard J Schuch, MD
• Richard John Thill, RN

• Licensed Practical Nurse in Gays Mills, WI
• Providers in Gays Mills, WI by specialty
• Licensed Practical Nurse in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2008; 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.