Livia Mona Wiemann, RN

Key facts

NPI

1467709154

Entity type

Individual (NPI type 1)

Primary specialty

Registered Nurse 163W00000X

License

158884-30 (WI)

Practice address

4391 Parklawn Dr
Windsor, WI 53598-9788

Phone

(608) 572-0304

NPI assigned

Aug 13, 2012

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Credentials

Registered Nurse

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 13, 2012.

{
    "created_epoch": "1344816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344816000000",
    "number": "1467709154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1112 BROADWAY DR",
            "city": "SUN PRAIRIE",
            "state": "WI",
            "postal_code": "535901090",
            "telephone_number": "608-358-8191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4391 PARKLAWN DR",
            "city": "WINDSOR",
            "state": "WI",
            "postal_code": "535989788",
            "telephone_number": "608-572-0304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEMANN",
        "first_name": "LIVIA",
        "middle_name": "MONA",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-13",
        "last_updated": "2012-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "158884-30",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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