Individual provider Active NPI

Devon Lynn Wittig, REGISTERD NURSE

  • Neonatal Intensive Care Registered Nurse
  • Waukesha, WI
National Provider Identifier
1205427556
Registry record updated Jan 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Intensive Care Registered NurseTaxonomy code 163WN0002X
License
170687-030 Issued in WI
Practice address
21550 Cologne Rd
Waukesha, WI 53186-5411
Phone
(414) 416-3929
NPI assigned
Jan 29, 2021
Last updated
Jan 29, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Intensive Care Registered Nurse 163WN0002X 170687-030 WI Primary

Addresses

Primary practice location

21550 Cologne Rd
Waukesha, WI 53186-5411

Mailing address

21550 Cologne Rd
Waukesha, WI 53186-5411
Phone (414) 416-3929

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
170687-030WIMDNeonatal Intensive Care Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1611878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611878400000",
    "number": "1205427556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21550 COLOGNE RD",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531865411",
            "telephone_number": "414-416-3929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21550 COLOGNE RD",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531865411",
            "telephone_number": "414-416-3929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITTIG",
        "first_name": "DEVON",
        "middle_name": "LYNN",
        "credential": "REGISTERD NURSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-29",
        "last_updated": "2021-01-29",
        "certification_date": "2021-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WN0002X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Neonatal Intensive Care",
            "state": "WI",
            "license": "170687-030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2021; 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.