MEDICARE: CAMERON PADDISON APNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP2300X	Primary Care Nurse Practitioner	17768-33	WI

General Provider Information

NPI Number	:	1699627596
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAMERON PADDISON APNP

Provider Business Mailing Address
First Line	:	4446 N BARTLETT AVE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53211-1507
Country	:	US
Telephone Number	:	858-449-3441
Fax Number	:

Provider Business Practice Location Address
First Line	:	675 N BARKER RD STE 100
Second Line	:
City	:	BROOKFIELD
State	:	WI
Zip	:	53045-5937
Country	:	US
Telephone Number	:	262-217-0299
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/12/2026
Last Update Date	:	02/12/2026

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