Wanda Lisa Street, APRN-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

RN140175 Issued in GA

Practice address

6600 Van Aalst Blvd
Fort Benning, GA 31905-2102

Phone

(706) 544-8688

NPI assigned

Aug 20, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Wanda Lisa Monroig Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Specialist

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Horizons North, Inc.

  • Counselor
  • Columbus, GA
  • NPI 1184736092
  NPD (past)
• Mercymed of Columbus Inc

  • Internal Medicine Physician
  • Columbus, GA
  • NPI 1639450877
  NPD (past)

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672272000000",
    "number": "1336254648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1654 OSSAHATCHIE CREEK RD",
            "city": "ELLERSLIE",
            "state": "GA",
            "postal_code": "318075342",
            "telephone_number": "706-582-3575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6600 VAN AALST BLVD",
            "city": "FORT BENNING",
            "state": "GA",
            "postal_code": "319052102",
            "telephone_number": "706-544-8688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STREET",
        "first_name": "WANDA",
        "middle_name": "LISA",
        "name_prefix": "Mrs.",
        "credential": "APRN-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-20",
        "last_updated": "2022-12-29",
        "certification_date": "2022-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "GA",
            "license": "RN140175",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN140175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WANDA",
            "last_name": "MONROIG",
            "middle_name": "LISA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Christina Marie Stavitski, M.D.
• Toby Stephan, MA, CCC-SLP
• Benjamin Stevens
• Zachary David Stewart, OD
• Michele Strage, PH.D
• Mary Scott Stuart, DDS
• Joshua Reid Stutzman, DMD
• Jennifer B Taff, M.ED.
• Kelsey H. Tatone, P.A.-C
• The Janz Corporation

• Psychiatric/Mental Health Nurse Practitioner in Fort Benning, GA
• Providers in Fort Benning, GA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Georgia

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

Verify at the official NPI Registry.