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
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
07/01/2021
Last updated
03/29/2023
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