Katrenia J Wycough, RN, A/GNP-C

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

251261 Issued in TX

Practice address

9900 Bren Road East
Minnetonka, MN 55343-9664

Phone

(903) 681-8334

NPI assigned

May 12, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Geriatric Associates of America-Texas, PLLC

  • Internal Medicine Physician
  • Webster, TX
  • NPI 1669682886

  Adult Health

  NPD (past)
• Geriatric Associates of America, P.a.

  • Geriatric Medicine (Family Medicine) Physician
  • Houston, TX
  • NPI 1093768673

  Adult Health

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600300800000",
    "number": "1023069242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9900 BREN RD E",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553439664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9900 BREN ROAD EAST",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553439664",
            "telephone_number": "903-681-8334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYCOUGH",
        "first_name": "KATRENIA",
        "middle_name": "J",
        "credential": "RN, A/GNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-12",
        "last_updated": "2020-09-17",
        "certification_date": "2020-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "251261",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "251261",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "29335903",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lauren Ann Wrede
• Jaqela Shanice Wrencher
• Kimberly Michelle Wright Fenner, FNP
• Alice Wright, APRN, FNP-C
• Jessica A Wright, LICENSED PSYCHOLOGIS
• Larry L Wynia
• Charlotte Casey Wynn, CRNP
• Kenneth James Wysocki, PHD, FNP
• Tiffany Lager Wyttenbach, FNP-C
• Ashely Ka Zoua Xiong, OTR/L

• Adult Health Nurse Practitioner in Minnetonka, MN
• Providers in Minnetonka, MN by specialty
• Adult Health Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.