Wise Woman Wellness LLC

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

115-030 Issued in WI

Legal business name

WISE WOMAN WELLNESS LLC

Practice address

1480 Swan Rd
De Pere, WI 54115-7966

Phone

(920) 339-5252

Fax

(920) 632-7652

NPI assigned

Nov 20, 2009

Last updated

Nov 20, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Randi Mary Mann, NPNPI 1427016609

Title

Owner

Phone

(920) 339-5252

Specialties & licenses 1

Addresses

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Randi Mann, NP

  • Nurse Practitioner
  • Green Bay, WI
  • NPI 1427016609
  NPD (past) Authorized official
• Amy Daily, CNM

  • Advanced Practice Midwife
  • Appleton, WI
  • NPI 1942732219
  NPD (past)

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

{
    "created_epoch": "1258675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258675200000",
    "number": "1033447594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1480 SWAN RD",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541157966",
            "telephone_number": "920-339-5252",
            "fax_number": "920-632-7652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1480 SWAN RD",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541157966",
            "telephone_number": "920-339-5252",
            "fax_number": "920-632-7652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISE WOMAN WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-20",
        "last_updated": "2009-11-20",
        "status": "A",
        "authorized_official_last_name": "MANN",
        "authorized_official_first_name": "RANDI",
        "authorized_official_middle_name": "MARY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "920-339-5252",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "WI",
            "license": "115-030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Paul Williams, LCSW
• Chelsea Wilson
• Jessica L. Wirkus, NP
• Wisconsin CVS Pharmacy LLC (CVS Pharmacy 02214)
• Wisconsin Tongue Tie Institute LLC
• Herbert J Wiser, MD
• Anna Wissink, PTA
• Emilee A Witt, M.A.
• Anne C Wollan, LPC
• Kyle P Wood, MD

• Women's Health Nurse Practitioner in De Pere, WI
• Providers in De Pere, WI by specialty
• Women's Health Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2009; 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.