Kim Woller, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

221487 Issued in WI

Practice address

319 Quaw Ave
Edgar, WI 54426-9316

Phone

(715) 352-3593

NPI assigned

Nov 17, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1416182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426118400000",
    "number": "1174929285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "319 QUAW AVE",
            "city": "EDGAR",
            "state": "WI",
            "postal_code": "544269316",
            "telephone_number": "715-352-3593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 QUAW AVE",
            "city": "EDGAR",
            "state": "WI",
            "postal_code": "544269316",
            "telephone_number": "715-352-3593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLLER",
        "first_name": "KIM",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-17",
        "last_updated": "2015-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "WI",
            "license": "318084",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "221487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• School District of Edgar
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• Connie Jean Zimmerman, RN

• Registered Nurse in Edgar, WI
• Providers in Edgar, WI by specialty
• Registered Nurse in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 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.