Active NPI
Kathryn Wynn Mittie, MSN, FNP
- Family Nurse Practitioner
- Madera, CA
National Provider Identifier
1942331236
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 16512
- Practice address
- 1280 E Almond Ave
Madera, CA 93637-5606 - Phone
- (559) 673-9021
- NPI assigned
- Mar 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 16512 | CA | Primary |
Addresses
Primary practice location
1280 E Almond Ave
Madera, CA 93637-5606
Mailing address
19650 Road 30 1/2
Madera, CA 93638
Phone (559) 662-1262
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)
- Enrolled
- Credentials
- Master of Science - Nursing, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16512 | CA | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1942331236",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19650 ROAD 30 1/2",
"city": "MADERA",
"state": "CA",
"postal_code": "93638",
"telephone_number": "559-662-1262"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1280 E ALMOND AVE",
"city": "MADERA",
"state": "CA",
"postal_code": "936375606",
"telephone_number": "559-673-9021"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MITTIE",
"first_name": "KATHRYN",
"middle_name": "WYNN",
"credential": "MSN, FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "16512",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Madera, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.