Individual provider Active NPI

Wanda N Brown, RN

  • Registered Nurse
  • Kerrville, TX
National Provider Identifier
1265619001
Registry record updated Jan 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
604987 Issued in TX
Practice address
819 Water St Ste 300
Kerrville, TX 78028-5330
Phone
(830) 258-5430
Fax
(830) 792-5771
NPI assigned
Jan 23, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 604987 TX Primary

Addresses

Primary practice location

819 Water St Ste 300
Kerrville, TX 78028-5330

Mailing address

819 Water St Ste 300
Kerrville, TX 78028-5330
Phone (830) 258-5430

Other identifiers 1

IdentifierTypeStateIssuer
604987OtherTXRN LICENSE

Other names 1

  • Wanda N Whitefield Former name

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
604987TXMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1201046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201046400000",
    "number": "1265619001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "819 WATER ST STE 300",
            "city": "KERRVILLE",
            "state": "TX",
            "postal_code": "780285330",
            "telephone_number": "830-258-5430",
            "fax_number": "830-792-5771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "819 WATER ST STE 300",
            "city": "KERRVILLE",
            "state": "TX",
            "postal_code": "780285330",
            "telephone_number": "830-258-5430",
            "fax_number": "830-792-5771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "WANDA",
        "middle_name": "N",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-23",
        "last_updated": "2008-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "604987",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "604987",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WANDA",
            "last_name": "WHITEFIELD",
            "middle_name": "N",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kerrville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2008; 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.