Gwendolyn Ann Wren, CACDP

Primary specialty

Nutrition Education NutritionistTaxonomy code 133NN1002X

License

133N1002X Issued in MI

Practice address

13336 E Warren Ave
Detroit, MI 48215-2112

Phone

(313) 822-6940

NPI assigned

Apr 3, 2012

Last updated

Apr 3, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1333411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333411200000",
    "number": "1023374139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2459 PARKER ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482141824",
            "telephone_number": "313-743-2540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13336 E WARREN AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482152112",
            "telephone_number": "313-822-6940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WREN",
        "first_name": "GWENDOLYN",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "CACDP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-03",
        "last_updated": "2012-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": "MI",
            "license": "133N1002X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wow Medical Transportation LLC
• Alexandra Woytych
• Tanya Wozniak, M.D.
• Nicole Woznicki, NP
• Riad Moh'D Wraikat, PH.D.
• James Wren Jr.
• Jaleesa Wrench
• Wright & Filippis, LLC
• Wright & Filippis, LLC
• Wright & Filippis, LLC

• Nutrition Education Nutritionist in Detroit, MI
• Providers in Detroit, MI by specialty
• Nutrition Education Nutritionist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2012; 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.