MRS. JERRICA BRIANNE VAUGHAN


Address: 4855 S Moorland Rd Ste 250, New Berlin, WI 53151-7494
Phone: 2627896020

MRS. JERRICA BRIANNE VAUGHAN (NPI# 1245768662) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1245768662
Entity Type Individual
Full Name MRS. JERRICA BRIANNE VAUGHAN
Credential CPNP-PC
Practice Address 4855 S Moorland Rd Ste 250
New Berlin
WI 53151-7494
Mailing Address 9000 W Wisconsin Ave # Ms 958
Milwaukee
WI 53226-4874
Practice Telephone 2627896020
Practice Fax Number 2627896025
Mailing Telephone 4142667615
Mailing Fax Number 4142666238
Enumeration Date 2017-05-30
Last Update Date 2018-10-30
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 163W00000X Registered Nurse 226174 WI Nursing Service Providers
Y 363LP0200X Nurse Practitioner
Specialization: Pediatrics
7420 WI Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
WI 1245768662 05

Office Location

Street Address 4855 S MOORLAND RD STE 250
City NEW BERLIN
State WI
Zip Code 53151-7494

Providers in the same location

NPI Name Taxonomy Address Enumeration
1851385157 William D Jeruc Pediatrics 4855 S Moorland Rd Ste 250, New Berlin, WI 53151-7494 2005-09-01
1457713711 Aaron Hanson Pediatrics 4855 S Moorland Rd Ste 250, New Berlin, WI 53151-7494 2016-03-25
1053723130 Benjamin Landgraf Pediatrics 4855 S Moorland Rd Ste 250, New Berlin, WI 53151-7494 2014-05-23
1770882078 Laura Diane Gray Pediatrics 4855 S Moorland Rd Ste 250, New Berlin, WI 53151-7494 2011-03-25
1326213562 Children's Medical Group Pediatrics 4855 S Moorland Rd Ste 250, New Berlin, WI 53151-7494 2008-04-29
1407966898 Jodi O Spahr Nurse Practitioner 4855 S Moorland Rd Ste 250, New Berlin, WI 53151-7494 2006-08-30
1104813328 Michael Gutzeit Pediatrics 4855 S Moorland Rd Ste 250, New Berlin, WI 53151-7494 2005-10-03
1710973334 Connie L Richter Pediatrics 4855 S Moorland Rd Ste 250, New Berlin, WI 53151-7494 2005-09-20
1871589390 Patti Marie Young Pediatrics 4855 S Moorland Rd Ste 250, New Berlin, WI 53151-7494 2005-09-20
1679569297 Robert T Rohloff Pediatrics 4855 S Moorland Rd Ste 250, New Berlin, WI 53151-7494 2005-09-20
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1629527486 Natural Look Salon and Wigs LLC Durable Medical Equipment & Medical Supplies 4805 S. Moorland Rd, New Berlin, WI 53151 2016-09-22
1396193033 New Berlin Medical Services, LLC Clinic/Center 15324 W Beloit Road, New Berlin, WI 53151 2016-06-02
1063899680 Costco Wholesale Corporation Eyewear Supplier (Equipment, not the service) 15300 West Grange Avenue, New Berlin, WI 53151 2015-05-04
1871970368 Mary Spath Physical Therapy Assistant 2810 South Acredale Road, New Berlin, WI 53151 2015-05-04
1669885471 Wauwatosa Prescription Center, Inc. Pharmacy 4855 S Moorland Road, New Berlin, WI 53151 2014-06-09
1750711446 Pure Family Chiropractic LLC Chiropractor 3504 S. Moorland Road, New Berlin, WI 53151 2013-11-18
1336578202 Hamilton John Dowden Chiropractor 3504 S Moorland Rd, New Berlin, WI 53151 2013-11-01
1053653618 Danielle Lynn Lucio Acupuncturist 15807 W. National Ave., New Berlin, WI 53151 2013-03-21
1306195110 Marlena J Friedrich Registered Nurse 1709 S. 171st Street, New Berlin, WI 53151 2012-09-07
1548519176 Patricia M Friedrich Licensed Practical Nurse 1709 So. 171st Street, New Berlin, WI 53151 2012-08-29
Find all providers in zip 53151

Taxonomy Information

Taxonomy Code 363LP0200X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Pediatrics

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1639685274 Laura Palmer Nurse Practitioner 4855 S Moorland Rd # Rod, New Berlin, WI 53151-7494 2017-12-19
1689878092 Kathleen Trier Mcwey Nurse Practitioner 3610 Michelle Witmer Memorial Dr, New Berlin, WI 53151-5292 2007-06-12
1013525096 Katherine Ciminelli Waller Nurse Practitioner 4855 S Moorland Rd Fl 3, New Berlin, WI 53151-7494 2020-07-16
1871041996 Theresa Sue Ignaczak Bullis Nurse Practitioner 4855 S Moorland Rd, New Berlin, WI 53151-7494 2016-09-18
1881057065 Anna B Pokrzywinski Nurse Practitioner 4855 S Moorland Rd Fl 3, New Berlin, WI 53151-7494 2016-04-04
1922314269 Alisa A Nehls Nurse Practitioner 4855 S Moorland Rd, New Berlin, WI 53151 2010-08-24
1386979193 Julie Bolha Nurse Practitioner 4855 S Moorland Rd, New Berlin, WI 53151-7494 2009-10-13
1407966898 Jodi O Spahr Nurse Practitioner 4855 S Moorland Rd Ste 250, New Berlin, WI 53151-7494 2006-08-30
1205857364 Meghan C. Belongia Nurse Practitioner 4855 S Moorland Rd, New Berlin, WI 53151-7494 2006-07-22
1063466191 Julie Ann Averbeck Nurse Practitioner 4855 S Moorland Rd, Suite 150, New Berlin, WI 53151-7494 2006-05-22
Find all providers in NEW BERLIN

Competitor

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City NEW BERLIN
Zip Code 53151

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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