Active NPI
Wendy Nielsen, FNP-BC
- Family Nurse Practitioner
- Mesa, AZ
National Provider Identifier
1508075664
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- RN057488
- Practice address
- 1718 S Los Alamos
Mesa, AZ 85204-7225 - Phone
- (602) 292-9065
- Fax
- (480) 248-9275
- NPI assigned
- May 22, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | RN057488 | AZ | Primary |
Addresses
Primary practice location
1718 S Los Alamos
Mesa, AZ 85204-7225
Mailing address
1718 S Los Alamos
Mesa, AZ 85204-7225
Phone (602) 292-9065
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RN057488 | Other | AZ | AZ STATE BOARD OF NURSING |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN057488 | AZ | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1473379200000",
"number": "1508075664",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1718 S LOS ALAMOS",
"city": "MESA",
"state": "AZ",
"postal_code": "852047225",
"telephone_number": "602-292-9065",
"fax_number": "480-248-9275"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1718 S LOS ALAMOS",
"city": "MESA",
"state": "AZ",
"postal_code": "852047225",
"telephone_number": "602-292-9065",
"fax_number": "480-248-9275"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NIELSEN",
"first_name": "WENDY",
"name_prefix": "Mrs.",
"credential": "FNP-BC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-22",
"last_updated": "2016-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "AZ",
"license": "RN057488",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AZ STATE BOARD OF NURSING",
"identifier": "RN057488",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2016; 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.