Active NPI
Patricia Wren
- Nurse Practitioner
- Midland, MI
National Provider Identifier
1205203072
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 4704123096
- Practice address
- 4201 Campus Ridge Dr Ste 3200
Midland, MI 48640-6135 - Phone
- (989) 488-5850
- Fax
- (989) 488-5865
- NPI assigned
- Aug 28, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 4704123096 | MI | |
| Nurse Practitioner | 363L00000X | 4704123096 | MI | Primary |
Addresses
Primary practice location
4201 Campus Ridge Dr Ste 3200
Midland, MI 48640-6135
Mailing address
4201 Campus Ridge Dr Ste 3200
Midland, MI 48640-6135
Phone (989) 488-5850
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704123096 | MI | MD | Nurse Practitioner |
Interoperability endpoints
- pwren61683@mymichiganhealth.midirect.net
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1440720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1205203072",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4201 CAMPUS RIDGE DR STE 3200",
"city": "MIDLAND",
"state": "MI",
"postal_code": "486406135",
"telephone_number": "989-488-5850",
"fax_number": "989-488-5865"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4201 CAMPUS RIDGE DR STE 3200",
"city": "MIDLAND",
"state": "MI",
"postal_code": "486406135",
"telephone_number": "989-488-5850",
"fax_number": "989-488-5865"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WREN",
"first_name": "PATRICIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-08-28",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MI",
"license": "4704123096",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MI",
"license": "4704123096",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Midland, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.