Elizabeth A Wiborg, RN CNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

CNP 2753 Issued in MN

Practice address

2450 26TH Ave S
Minneapolis, MN 55406-1245

Phone

(612) 721-2491

NPI assigned

Mar 21, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ewiborg@landmarkhealth-direct.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Affiliated Community Medical Centers, LTD

  • Multi-Specialty Clinic/Center
  • Willmar, MN
  • NPI 1952363699
  NPD
• Carris Health LLC

  • Multi-Specialty Clinic/Center
  • Willmar, MN
  • NPI 1598236408
  NPD

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

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578441600000",
    "number": "1154380871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7755 CENTER AVE",
            "address_2": "STE 630",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926479152",
            "telephone_number": "657-400-5180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 26TH AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554061245",
            "telephone_number": "612-721-2491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIBORG",
        "first_name": "ELIZABETH",
        "middle_name": "A",
        "credential": "RN CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-21",
        "last_updated": "2020-01-08",
        "certification_date": "2020-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MN",
            "license": "R 94784-6",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MN",
            "license": "CNP 2753",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "504536600",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nathan Charles Whittier, PSYD, ABPP
• Rhonda Whitton
• Whole Builders Cooperative
• Whole Living Chiropractic
• Cody Wiberg, PHARM.D., R.PH.
• Nancy L Wiborg, CNS
• Wicare Home Care LLC
• Carol Frances Wichers, LICSW.,LMFT
• Lora Margit Heim Wichser, M.D.
• Theresa Kaye Wichser, PTA

• Gerontology Nurse Practitioner in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Gerontology Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2020; 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.