Kimberly Ann Wanen, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

PN111300MIV Issued in OH

Practice address

8693 Lake Forest CT
Chagrin Falls, OH 44023-5654

Phone

(440) 223-0870

NPI assigned

Jun 18, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Kimberly Ann Wanen Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1276819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276819200000",
    "number": "1194046607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8693 LAKE FOREST CT",
            "city": "CHAGRIN FALLS",
            "state": "OH",
            "postal_code": "440235654",
            "telephone_number": "440-223-0870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8693 LAKE FOREST CT",
            "city": "CHAGRIN FALLS",
            "state": "OH",
            "postal_code": "440235654",
            "telephone_number": "440-223-0870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANEN",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-18",
        "last_updated": "2010-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN111300MIV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "WANEN",
            "middle_name": "ANN",
            "credential": "LPN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Christina Gertrude Vonhaz, NP
• Cheryl Forino Wahl, JD
• Walgreen Co
• Kathryn Walsh, OT
• Jaclyn Walton
• Andrea Ward, MD
• Carol Warnick, EDS
• Washington Square Chiropractic Clinic, LLC
• Tracy Woodrow Watson Jr., CRNA
• Susan Levy Wayne

• Licensed Practical Nurse in Chagrin Falls, OH
• Providers in Chagrin Falls, OH by specialty
• Licensed Practical Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2010; 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.