IMELDA N FORSBERG NURSE PRACTITIONER NPI 1306027891

NPI Information

NPI: 1306027891
Provider Name: IMELDA N FORSBERG, NURSE PRACTITIONER
Classification: Nurse Practitioner - 363LA2200X
Entity Type: Individual

Specialization: Adult Health

PECOS Registration: Yes

Address:
6430 GREENBAY RD
SUITE 104
KENOSHA, WI
ZIP 53142
Phone: (262) 925-0535
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Imelda N Forsberg, NURSE PRACTITIONER is an adult health nurse practitioner in Kenosha, WI. Imelda N Forsberg, NURSE PRACTITIONER NPI is 1306027891. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

6430 GREENBAY RD
SUITE 104
KENOSHA, WI
ZIP 53142-948
Phone: (262) 925-0535
Fax: (262) 925-0538

The NPI 1306027891 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/26/2007 and was last updated on 9/14/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LA2200X	Nurse Practitioner	Adult Health	209.006867	ILLINOIS	No
2	363LA2200X	Nurse Practitioner	Adult Health	4854	WISCONSIN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	4854-33	OTHER	WISCONSIN	STATE LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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