Active NPI
Kim Wisneski
- School Registered Nurse
- Los Lunas, NM
National Provider Identifier
1093136079
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Registered Nurse
- License
- R44816
- Practice address
- 3701 Sundance St.
Los Lunas, NM 87031 - Phone
- (505) 866-0185
- Fax
- (505) 866-0302
- NPI assigned
- Dec 18, 2013
- 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 |
|---|---|---|---|---|
| School Registered Nurse | 163WS0200X | R44816 | NM | Primary |
Addresses
Primary practice location
3701 Sundance St.
Los Lunas, NM 87031
Mailing address
3701 Sundance St.
Los Lunas, NM 87031
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R44816 | NM | MD | School Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1387324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1387324800000",
"number": "1093136079",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3701 SUNDANCE ST.",
"city": "LOS LUNAS",
"state": "NM",
"postal_code": "87031"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3701 SUNDANCE ST.",
"city": "LOS LUNAS",
"state": "NM",
"postal_code": "87031",
"telephone_number": "505-866-0185",
"fax_number": "505-866-0302"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WISNESKI",
"first_name": "KIM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-12-18",
"last_updated": "2013-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "163WS0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, School",
"state": "NM",
"license": "R44816",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Lunas, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.