Organization · Type 2 NPI
Ideal Community Living
Diabetes Educator Registered Nurse · Brown Deer, WI
NPI number
1194688747
Active
Practice location
3900 W Brown Deer Rd Ste C9
Brown Deer, WI 53209-1220
Fax (855) 853-8249
Mailing address
PO Box 1111
West Bend, WI 53095-8611
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Adult Development & Aging Psychologist | 103TA0700X | None listed |
| Dietary Manager | 132700000X | None listed |
| Nutritionist | 133N00000X | None listed |
| Nutrition Education Nutritionist | 133NN1002X | None listed |
| Pediatric Nutrition Registered Dietitian | 133VN1004X | None listed |
| Obesity and Weight Management Nutrition Registered Dietitian | 133VN1201X | None listed |
| Diabetes Educator Registered Nurse Primary | 163WD0400X | None listed |
| Health & Wellness Coach | 171400000X | None listed |
| Interpreter | 171R00000X | None listed |
| Meals Provider | 174200000X | None listed |
| Diabetology (Internal Medicine) Physician | 207QB0505X | None listed |
| Diabetology (Family Medicine) Physician | 207QD0401X | None listed |
| Home Health Agency | 251E00000X | None listed |
| Alzheimer Center (Dementia Center) | 311500000X | None listed |
| Prevention Professional | 405300000X | None listed |
Diabetes Educator Registered Nurse: Definition to come...
2 other providers at this address
About NPI 1194688747
Ideal Community Living's National Provider Identifier is 1194688747, issued on Dec 9, 2025. The primary taxonomy on file is Diabetes Educator Registered Nurse (163WD0400X), and the practice location is in Brown Deer, WI. The record was last updated on Dec 17, 2025.