Jill Wackler

Primary specialty

Case Management Registered NurseTaxonomy code 163WC0400X

License

2471754 Issued in MN

Practice address

2404 Greenbriar LN
Buffalo, MN 55313-2368

Phone

(763) 923-5254

NPI assigned

Apr 16, 2019

Last updated

Apr 16, 2019By the provider in NPPES

Sex

Female

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": "1555372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555372800000",
    "number": "1689237638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2404 GREENBRIAR LN",
            "city": "BUFFALO",
            "state": "MN",
            "postal_code": "553132368",
            "telephone_number": "763-923-5254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2404 GREENBRIAR LN",
            "city": "BUFFALO",
            "state": "MN",
            "postal_code": "553132368",
            "telephone_number": "763-923-5254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WACKLER",
        "first_name": "JILL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-16",
        "last_updated": "2019-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "MN",
            "license": "2471754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan G Van Pelt, MD
• Rita Rae Varner-Otness, D.C.
• Lydia Marie Vetsch
• Nicole Marie Vilmo
• Jeffrey Vossen
• Todd Wahlstrom, RPH
• Wal-Mart Stores, Inc. (Vision Center 30-1577)
• Barbara Elizabeth Waldorf, OTR/L
• Walgreen Co (Walgreens #15124)
• Marah Rae Walker, MSW, LICSW

• Case Management Registered Nurse in Buffalo, MN
• Providers in Buffalo, MN by specialty
• Case Management Registered Nurse in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2019; 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.