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Organization
IHC PLEASANT PRAIRIE INPATIENT SERVICES LLC
Active
Organization
IHC PLEASANT PRAIRIE INPATIENT SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN MARIE VAUGHN (OFFICER)
(973) 251-1132
Entity
Organization
Contact information
Practice address
9555 76TH ST, PLEASANT PRAIRIE, WI 53158-1984
(262) 577-8000
Mailing address
5565 CENTERVIEW DR STE 107, RALEIGH, NC 27606-3563
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
NULL
207R00000X
Internal Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
NULL
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
07/01/2021
Last updated
03/29/2023
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