Louise M Wickham, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

12.009638 Issued in CT

Practice address

12 Woodbine Rd
Colchester, CT 06415-1883

Phone

(860) 501-0590

NPI assigned

Feb 19, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1424304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630886400000",
    "number": "1851783476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 WOODBINE RD",
            "city": "COLCHESTER",
            "state": "CT",
            "postal_code": "064151883",
            "telephone_number": "860-501-0590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 WOODBINE RD",
            "city": "COLCHESTER",
            "state": "CT",
            "postal_code": "064151883",
            "telephone_number": "860-501-0590"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "53 Wolcott Hill Rd",
            "address_purpose": "LOCATION",
            "city": "Wethersfield",
            "state": "CT",
            "postal_code": "061091103",
            "country_code": "US",
            "telephone_number": "888-888-8888",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WICKHAM",
        "first_name": "LOUISE",
        "middle_name": "M",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-19",
        "last_updated": "2021-09-06",
        "certification_date": "2021-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CT",
            "license": "113269",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CT",
            "license": "12.009638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Denise Ward, PT
• Brenda Cote Webster, PTA
• Rebecca Wengloski, PTA
• Westchester Eye Care
• Westchester Family Dental
• Carol Wierzbinski Wikarska, LMT
• Wild Apple Eye II LLC
• Wildwood Wellness
• Charlene Ann Willax, RN
• Julie Danielle Willing, LCSW

• Adult Health Nurse Practitioner in Colchester, CT
• Providers in Colchester, CT by specialty
• Adult Health Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2021; 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.