Wendy Nicole Blethen, NNP-BC
Individual provider Active NPI Neonatal Nurse Practitioner · Jackson, MS
NPI 1174568752 · NPPES record last updated Feb 3, 2016
Key facts
- NPI
- 1174568752
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Neonatal Nurse Practitioner 363LN0000X
- License
- ARNP9391501 (FL)
- Practice address
- 2500 N State St
Jackson, MS 39216-4500 - Phone
- (601) 984-5262
- NPI assigned
- Jun 18, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
- 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 |
|---|---|---|---|---|
| I20080722000015 | MS | Practitioner - Nurse Practitioner | 3274606454 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R862823 | MS | MD | Neonatal Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| State of Mississippi-University of Mississippi Medical Center | Current |
Accepting new patients | |
| State of Mississippi - University of Mississippi Medical Center | Current | Accepting new patients | |
| State of Mississippi - University of Mississippi Medical Center | Current |
Accepting new patients |
Locations
6051 U S Highway 49
Hattiesburg, MS 39401
Phone (601) 288-2690
2500 N State St
Jackson, MS 39216
Phone (601) 815-4775
1815 Hospital Dr
Jackson, MS 39204
Phone (601) 815-4775
Interoperability endpoints
- wblethen@direct.mhg.com
- wblethen6515@ummc.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neonatal Nurse Practitioner | 363LN0000X | R862823 | MS | |
| Neonatal Nurse Practitioner | 363LN0000X | ARNP9391501 | FL | Yes |
Addresses
Primary practice location
2500 N State St
Jackson, MS 39216-4500
Mailing address
2500 N State St
Jackson, MS 39216-4500
Phone (601) 984-5262
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 08577001 | Medicaid | MS |
Other providers in Jackson, MS
- Adam K Blanks
- Kailin Danielle Blanton
- Betty Ann Blasi
- Blessings Beyond
- Blessings Beyond
- Phillip Blevins
- Tasha Blevins
- Lauren Smythe Bloodworth
- Bloom Health Services for Women
- Philip J Blount
All providers in Jackson, MS · Neonatal Nurse Practitioner in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 3, 2016. 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.