Individual provider Active NPI

Anna E Warzala, LPN

  • Licensed Practical Nurse
  • Jefferson, WI
National Provider Identifier
1740804913
Registry record updated Jun 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
325109 Issued in WI
Practice address
Sunset Ridge Jefferson
826 E. Reinel Street, Jefferson, Wi 53549
Jefferson, WI 53549
Phone
(262) 325-7516
Fax
(920) 541-3662
NPI assigned
Jun 3, 2020
Last updated
Jun 3, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 325109 WI Primary

Addresses

Primary practice location

Sunset Ridge Jefferson
826 E. Reinel Street, Jefferson, Wi 53549
Jefferson, WI 53549

Mailing address

Sunset Ridge Jefferson
826 E. Reinel Street, Jefferson, Wi 53549
Jefferson, WI 53549
Phone (262) 325-7516

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
325109WIMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1591142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591142400000",
    "number": "1740804913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "SUNSET RIDGE JEFFERSON",
            "address_2": "826 E. REINEL STREET, JEFFERSON, WI 53549",
            "city": "JEFFERSON",
            "state": "WI",
            "postal_code": "53549",
            "telephone_number": "262-325-7516",
            "fax_number": "920-541-3662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SUNSET RIDGE JEFFERSON",
            "address_2": "826 E. REINEL STREET, JEFFERSON, WI 53549",
            "city": "JEFFERSON",
            "state": "WI",
            "postal_code": "53549",
            "telephone_number": "262-325-7516",
            "fax_number": "920-541-3662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARZALA",
        "first_name": "ANNA",
        "middle_name": "E",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-03",
        "last_updated": "2020-06-03",
        "certification_date": "2020-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WI",
            "license": "325109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 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.