Active NPI
Amanda Moldenhauer
- Community Health Worker
- Winona, MN
National Provider Identifier
1952080459
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- Practice address
- 855 E Wabasha St
Winona, MN 55987-4739 - Phone
- (507) 313-0796
- NPI assigned
- Jul 13, 2023
- Last updated
- Jul 13, 2023
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | MN | Primary |
Addresses
Primary practice location
855 E Wabasha St
Winona, MN 55987-4739
Mailing address
855 E Wabasha St
Winona, MN 55987-4739
Phone (507) 313-0796
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1689206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689206400000",
"number": "1952080459",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "855 E WABASHA ST",
"city": "WINONA",
"state": "MN",
"postal_code": "559874739",
"telephone_number": "507-313-0796"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "855 E WABASHA ST",
"city": "WINONA",
"state": "MN",
"postal_code": "559874739",
"telephone_number": "507-313-0796"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOLDENHAUER",
"first_name": "AMANDA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-07-13",
"last_updated": "2023-07-13",
"certification_date": "2023-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "MN",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winona, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.