Patience Wenck, FNP
Individual provider Active NPI Family Nurse Practitioner · South Lake Tahoe, CA
NPI 1124238548 · NPPES record last updated Jul 16, 2014
Key facts
- NPI
- 1124238548
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 5903 (CA)
- Practice address
- 1154 Emerald Bay Rd
South Lake Tahoe, CA 96150-6288 - Phone
- (530) 542-4961
- Fax
- (530) 542-4964
- NPI assigned
- May 23, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110927000101 | CA | Practitioner - Nurse Practitioner | 5597935288 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5903 | CA | MD | Clinical Social Worker |
| APN00263 | NV | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of Alpine | Current |
Accepting new patients | |
| Emerald Bay Center for Women'S Health, Inc. | Past | Accepting new patients | |
| Jorge Perez MD LTD | Past |
Accepting new patients |
Locations
75 Diamond Valley Rd
Unit B
Markleeville, CA 96120
Phone (530) 694-2146
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 5903 | CA | Yes |
| Family Nurse Practitioner | 363LF0000X | APN00263 | NV |
Addresses
Primary practice location
1154 Emerald Bay Rd
South Lake Tahoe, CA 96150-6288
Mailing address
1154 Emerald Bay Rd
South Lake Tahoe, CA 96150-6288
Phone (530) 542-4961
Other providers in South Lake Tahoe, CA
- Amanda Stevens Weavil
- Dustin John Wedekind
- Eve-Marie Welch
- Joshua Welch
- Wellness Diagnostics
- Charles Patrick Wettach
- Lauren White
- Brent Maxwell Wilkinson
- Susan E Willey
- William a. Downey O.D. Inc
All providers in South Lake Tahoe, CA · Family Nurse Practitioner in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 16, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.