Active NPI
Jean M Wildauer, NP
- Nurse Practitioner
- Reading, PA
National Provider Identifier
1467563197
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- SP006245C
- Practice address
- 120 Prospect St
Reading, PA 19606-2871 - Phone
- (610) 779-1330
- Fax
- (610) 779-5929
- NPI assigned
- Aug 31, 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | SP006245C | PA | Primary |
Addresses
Primary practice location
120 Prospect St
Reading, PA 19606-2871
Mailing address
19 Sunrise Drive
Lebanon, PA 17042-8010
Phone (717) 274-3912
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 |
|---|---|---|---|
| SP006245C | PA | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1216598400000",
"number": "1467563197",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19 SUNRISE DRIVE",
"city": "LEBANON",
"state": "PA",
"postal_code": "170428010",
"telephone_number": "717-274-3912",
"fax_number": "717-274-3912"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 PROSPECT ST",
"city": "READING",
"state": "PA",
"postal_code": "196062871",
"telephone_number": "610-779-1330",
"fax_number": "610-779-5929"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILDAUER",
"first_name": "JEAN",
"middle_name": "M",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-31",
"last_updated": "2008-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "PA",
"license": "SP006245C",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Reading, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.