Active NPI
Wanda D Freese, ARNP
- Family Nurse Practitioner
- Ida Grove, IA
National Provider Identifier
1366498529
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- A-050945
- Practice address
- 700 E 2ND St
Ida Grove, IA 51445-1601 - Phone
- (712) 364-2514
- Fax
- (712) 364-4430
- NPI assigned
- May 26, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | A-050945 | IA | Primary |
Addresses
Primary practice location
700 E 2ND St
Ida Grove, IA 51445-1601
Mailing address
700 E 2ND St
Ida Grove, IA 51445-1601
Phone (712) 364-2514
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A-050945 | IA | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1379030400000",
"number": "1366498529",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "700 E 2ND ST",
"city": "IDA GROVE",
"state": "IA",
"postal_code": "514451601",
"telephone_number": "712-364-2514",
"fax_number": "712-364-4430"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 E 2ND ST",
"city": "IDA GROVE",
"state": "IA",
"postal_code": "514451601",
"telephone_number": "712-364-2514",
"fax_number": "712-364-4430"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREESE",
"first_name": "WANDA",
"middle_name": "D",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-26",
"last_updated": "2013-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IA",
"license": "A-050945",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ida Grove, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.