Jennifer L Wildeman, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

13-95694-111 Issued in KS

Practice address

112 S Kansas Ave
Norton, KS 67654-2111

Phone

(785) 622-4254

NPI assigned

Sep 4, 2018

Last updated

Sep 4, 2018By 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

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1536019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536019200000",
    "number": "1831671023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 S KANSAS AVE",
            "city": "NORTON",
            "state": "KS",
            "postal_code": "676542111",
            "telephone_number": "785-622-4254",
            "fax_number": "785-622-4256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 S KANSAS AVE",
            "city": "NORTON",
            "state": "KS",
            "postal_code": "676542111",
            "telephone_number": "785-622-4254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDEMAN",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-04",
        "last_updated": "2018-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KS",
            "license": "13-95694-111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Nurse in Norton, KS
• Providers in Norton, KS by specialty
• Registered Nurse in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2018; 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.