# IHC PLEASANT PRAIRIE INPATIENT SERVICES LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053982926
- **Authorized official:** KAREN MARIE VAUGHN (OFFICER)
- **Authorized official phone:** (973) 251-1132

## Contact information

- **Practice address:** 9555 76TH ST, PLEASANT PRAIRIE, WI 53158-1984
- **Practice address phone:** (262) 577-8000
- **Mailing address:** 5565 CENTERVIEW DR STE 107, RALEIGH, NC 27606-3563

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |
| 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