Brian Glen Wombles

Primary specialty

Licensed Vocational NurseTaxonomy code 164X00000X

License

2035078 Issued in KY

Practice address

5016 Watercrest Rd Apt 9104
Killeen, TX 76549-6380

Phone

(270) 707-6146

NPI assigned

May 12, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1589241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589241600000",
    "number": "1619599735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5016 WATERCREST RD APT 9104",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765496380",
            "telephone_number": "270-707-6146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5016 WATERCREST RD APT 9104",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765496380",
            "telephone_number": "270-707-6146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOMBLES",
        "first_name": "BRIAN",
        "middle_name": "GLEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-12",
        "last_updated": "2020-05-12",
        "certification_date": "2020-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "KY",
            "license": "2035078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Klorice Kamisha Witherspoon, CHW
• Kim Wizeman
• Richard R Woehrle, DDS
• Jovanna Castaneda Wolf, APRN, WHNP-BC
• Annette Michelle Wolff, O.D.
• James R Wood, MD
• Shari Angelique Woodard, REGISTERED NURSE
• Shauntrice Woodberry
• Tanyika Woodberry, LPC
• Dena Ann Woodell Fogle, FNP

• Licensed Vocational Nurse in Killeen, TX
• Providers in Killeen, TX by specialty
• Licensed Vocational Nurse in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.