Individual provider Active NPI

Tina Wrzesinski, LPN

  • Licensed Practical Nurse
  • Overland, MO
National Provider Identifier
1326282971
Registry record updated Apr 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
057401 Issued in MO
Practice address
8511 Midland Blvd
Overland, MO 63114-5923
Phone
(314) 423-1172
NPI assigned
Apr 27, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2009

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 057401 MO Primary

Addresses

Primary practice location

8511 Midland Blvd
Overland, MO 63114-5923

Mailing address

8511 Midland Blvd
Overland, MO 63114-5923
Phone (314) 423-1172

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
057401MOMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1240790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240790400000",
    "number": "1326282971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8511 MIDLAND BLVD",
            "city": "OVERLAND",
            "state": "MO",
            "postal_code": "631145923",
            "telephone_number": "314-423-1172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8511 MIDLAND BLVD",
            "city": "OVERLAND",
            "state": "MO",
            "postal_code": "631145923",
            "telephone_number": "314-423-1172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRZESINSKI",
        "first_name": "TINA",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-27",
        "last_updated": "2009-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MO",
            "license": "057401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2009; 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.