Active NPI
Victoria Cannella, RN
- Addiction (Substance Use Disorder) Registered Nurse
- Wausau, WI
National Provider Identifier
1073841458
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Registered Nurse
- License
- 170462-30
- Practice address
- 209 W Washington St
Suite B
Wausau, WI 54403-5475 - Phone
- (715) 845-3637
- NPI assigned
- Nov 24, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Registered Nurse | 163WA0400X | 170462-30 | WI | Primary |
Addresses
Primary practice location
209 W Washington St
Suite B
Wausau, WI 54403-5475
Mailing address
209 W Washington St
Suite B
Wausau, WI 54403-5475
Phone (715) 845-3637
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 170462-30 | WI | MD | Addiction (Substance Use Disorder) Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1259020800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1259020800000",
"number": "1073841458",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "209 W WASHINGTON ST",
"address_2": "SUITE B",
"city": "WAUSAU",
"state": "WI",
"postal_code": "544035475",
"telephone_number": "715-845-3637"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "209 W WASHINGTON ST",
"address_2": "SUITE B",
"city": "WAUSAU",
"state": "WI",
"postal_code": "544035475",
"telephone_number": "715-845-3637"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CANNELLA",
"first_name": "VICTORIA",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-11-24",
"last_updated": "2009-11-24",
"status": "A"
},
"taxonomies": [
{
"code": "163WA0400X",
"taxonomy_group": "",
"desc": "Registered Nurse, Addiction (Substance Use Disorder)",
"state": "WI",
"license": "170462-30",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wausau, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 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.