Organization Active NPI

Wound Resource Professional Corporation

  • Family Nurse Practitioner
  • Lancaster, CA
National Provider Identifier
1164396602
Registry record updated Oct 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
WOUND RESOURCE PROFESSIONAL CORPORATION
Practice address
7262 Sunnyslope Dr
Lancaster, CA 93536-7363
Phone
(702) 612-6316
NPI assigned
Sep 29, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2025

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

Authorized official

Name
Shanna RuckerNPI 1194307421
Title
Owner
Phone
(702) 612-6316

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

7262 Sunnyslope Dr
Lancaster, CA 93536-7363

Mailing address

8416 Delco Ave
Winnetka, CA 91306-1317

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1759104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759363200000",
    "number": "1164396602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8416 DELCO AVE",
            "city": "WINNETKA",
            "state": "CA",
            "postal_code": "913061317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7262 SUNNYSLOPE DR",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935367363",
            "telephone_number": "702-612-6316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOUND RESOURCE PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-29",
        "last_updated": "2025-10-02",
        "certification_date": "2025-10-02",
        "status": "A",
        "authorized_official_last_name": "RUCKER",
        "authorized_official_first_name": "SHANNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-612-6316"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2025; 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.