Individual provider Active NPI

Cynthia Fay Wenzel, LPN

  • Licensed Practical Nurse
  • Manitowoc, WI
National Provider Identifier
1306177225
Registry record updated Apr 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
302900-031 Issued in WI
Practice address
915 East Linden Avenue
Manitowoc, WI 54220
Phone
(920) 652-4634
NPI assigned
Jan 15, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 302900-031 WI Primary

Addresses

Primary practice location

915 East Linden Avenue
Manitowoc, WI 54220

Mailing address

915 East Linden Avenue
Manitowoc, WI 54220
Phone (920) 652-4634

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
302900-031WIMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1263513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334275200000",
    "number": "1306177225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 EAST LINDEN AVENUE",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "54220",
            "telephone_number": "920-652-4634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 EAST LINDEN AVENUE",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "54220",
            "telephone_number": "920-652-4634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENZEL",
        "first_name": "CYNTHIA",
        "middle_name": "FAY",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-15",
        "last_updated": "2012-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WI",
            "license": "302900-031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manitowoc, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2012; 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.