Individual provider Active NPI

Susan Kaye Vollmer, RN,CNNP

  • Neonatal Intensive Care Registered Nurse
  • Green Bay, WI
National Provider Identifier
1942474259
Registry record updated Apr 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Intensive Care Registered NurseTaxonomy code 163WN0002X
License
069968-6 Issued in MN
Practice address
1259 Prairie Falcon TRL
Green Bay, WI 54313-7177
Phone
(920) 434-9143
NPI assigned
Apr 17, 2008
Last updated
Apr 17, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Intensive Care Registered Nurse 163WN0002X 069968-6 MN Primary

Addresses

Primary practice location

1259 Prairie Falcon TRL
Green Bay, WI 54313-7177

Mailing address

1259 Prairie Falcon TRL
Green Bay, WI 54313-7177
Phone (920) 434-9143

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
069968-6MNMDNeonatal Intensive Care Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1208390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208390400000",
    "number": "1942474259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1259 PRAIRIE FALCON TRL",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543137177",
            "telephone_number": "920-434-9143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1259 PRAIRIE FALCON TRL",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543137177",
            "telephone_number": "920-434-9143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VOLLMER",
        "first_name": "SUSAN",
        "middle_name": "KAYE",
        "credential": "RN,CNNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-17",
        "last_updated": "2008-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WN0002X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Neonatal Intensive Care",
            "state": "MN",
            "license": "069968-6",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2008; 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.