Kimberley Elizabeth Wengrove, N.P.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

77745 Issued in CO

Practice address

1601 E 4TH Plain Blvd
V3-HBPC
Vancouver, WA 98661

Phone

(360) 905-1749

Fax

(360) 690-0343

NPI assigned

Jul 8, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659052800000",
    "number": "1447283064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36006 BRYANT DR SW",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973211853",
            "telephone_number": "303-895-7076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 E 4TH PLAIN BLVD",
            "address_2": "V3-HBPC",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "98661",
            "telephone_number": "360-905-1749",
            "fax_number": "360-690-0343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENGROVE",
        "first_name": "KIMBERLEY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-08",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CO",
            "license": "77745",
            "primary": false
        },
        {
            "code": "363LC1500X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Community Health",
            "state": "CO",
            "license": "77745",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CO",
            "license": "77745",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CO",
            "license": "77745",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "77745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelsea Welsh
• Morgan K Welter
• Wendel Family Dental Centre PS
• Roger Wendel, DMD
• Kristi Lynn Wendell, BA
• Corliss Wentworth, COUNSELOR
• Amara Michelle Wentz, BA
• Denise A Wentzel, PT
• Ellen Mercedes Wenzel, DPM
• Jean Rae Werner, RPH

• Family Nurse Practitioner in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Family Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.