Nicole K Wyganowski, RN, PHN, LSN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

502858 Issued in MN

Practice address

706 1St St
Princeton, MN 55371-1502

Phone

(763) 389-6195

NPI assigned

Sep 23, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Nicole K Heidinger Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mille Lacs Isanti & Sherburne Cos

  • Local Education Agency (LEA)
  • Princeton, MN
  • NPI 1427271089
  NPD Authorized official
• Mille Lacs Isanti & Sherburne Cos

  • State or Local Public Health Clinic/Center
  • Princeton, MN
  • NPI 1447093927
  NPD Authorized official

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

{
    "created_epoch": "1663891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667174400000",
    "number": "1720701709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30127 105TH ST",
            "city": "PRINCETON",
            "state": "MN",
            "postal_code": "553716170",
            "telephone_number": "612-419-0211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "706 1ST ST",
            "city": "PRINCETON",
            "state": "MN",
            "postal_code": "553711502",
            "telephone_number": "763-389-6195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYGANOWSKI",
        "first_name": "NICOLE",
        "middle_name": "K",
        "credential": "RN, PHN, LSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-23",
        "last_updated": "2022-10-31",
        "certification_date": "2022-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "MN",
            "license": "17656",
            "primary": false
        },
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "MN",
            "license": "502858",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "502858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "NA",
            "affiliation": "N",
            "address_1": "706 1st St",
            "city": "Princeton",
            "state": "MN",
            "country_code": "US",
            "postal_code": "553711502",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "HEIDINGER",
            "middle_name": "K",
            "credential": "RN, PHN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lucas Burton Winskowski, LADC
• Barbara Lynn Wisniewski, LPCC
• Renae Helen Witta, OTR/L
• Amanda Wolfsteller
• Woodland Dental LLC
• Michael A Zurek, MD

• Registered Nurse in Princeton, MN
• Providers in Princeton, MN by specialty
• Registered Nurse in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2022; 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.