Mary Ann Wichmann
Individual provider Active NPI Athletic Trainer · Rochert, MN
NPI 1164069431 · NPPES record last updated Dec 5, 2019
Key facts
- NPI
- 1164069431
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- Practice address
- 20338 County Highway 29
Rochert, MN 56578-9608 - Phone
- (218) 849-1091
- NPI assigned
- Dec 5, 2019
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | Yes |
Addresses
Primary practice location
20338 County Highway 29
Rochert, MN 56578-9608
Mailing address
20338 County Highway 29
Rochert, MN 56578-9608
Phone (218) 849-1091
Other providers in Rochert, MN
All providers in Rochert, MN · Athletic Trainer in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 5, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.