Individual provider Active NPI

Wanda Brown

  • Registered Nurse
  • Kalamazoo, MI
National Provider Identifier
1144690553
Registry record updated Sep 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
4704229644 Issued in MI
Practice address
418 W Kalamazoo Ave
Kalamazoo, MI 49007-3334
Phone
(269) 553-7038
Fax
(269) 382-0019
NPI assigned
Sep 28, 2015
Last updated
Sep 28, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 4704229644 MI Primary

Addresses

Primary practice location

418 W Kalamazoo Ave
Kalamazoo, MI 49007-3334

Mailing address

3299 Gull Rd
Kalamazoo, MI 49048-1281
Phone (269) 553-7038

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

LicenseStateTypeSpecialty
4704229644MIMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1443398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443398400000",
    "number": "1144690553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3299 GULL RD",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490481281",
            "telephone_number": "269-553-7038",
            "fax_number": "269-382-0019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418 W KALAMAZOO AVE",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490073334",
            "telephone_number": "269-553-7038",
            "fax_number": "269-382-0019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "WANDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-28",
        "last_updated": "2015-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704229644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2015; 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.