SEPTEMBER LEIGH WANZENRIED (NPI# 1073030607) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073030607 |
| Entity Type | Individual |
| Full Name | SEPTEMBER LEIGH WANZENRIED |
| Credential | APRN |
| Practice Address |
6901 S 84th St La Vista NE 68128 |
| Mailing Address |
5205 Cass St Omaha NE 68132-2818 |
| Practice Telephone | 8663892727 |
| Mailing Telephone | 4023014348 |
| Enumeration Date | 2017-08-24 |
| Last Update Date | 2018-06-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | 2004 | NE | Allopathic & Osteopathic Physicians |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
A148987 | IA | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
112351 | NE | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1000 S 178th St, Omaha, NE 681183542 | 8883337520 |
| Street Address |
6901 S 84TH ST |
| City | LA VISTA |
| State | NE |
| Zip Code | 68128 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952650608 | Kimberly Ann Wohlwend | Registered Nurse | 6901 S 84th St, La Vista, NE 68128-2127 | 2012-09-09 |
| 1376165589 | Michael Lindsay Cordwin | Pharmacist | 6901 S 84th St, La Vista, NE 68128-2127 | 2020-05-11 |
| 1326674300 | Ronna Jo Willsey | Pharmacist | 6901 S 84th St, La Vista, NE 68128-2127 | 2020-03-21 |
| 1215563903 | Christopher John Brosnihan | Pharmacist | 6901 S 84th St, La Vista, NE 68128-2127 | 2020-03-13 |
| 1053946111 | Jesse Thompson | Pharmacist | 6901 S 84th St, La Vista, NE 68128-2127 | 2020-03-10 |
| 1700411063 | Beth Dvorak | Pharmacist | 6901 S 84th St, La Vista, NE 68128-2127 | 2020-03-06 |
| 1457993750 | Fredericka Jackson | Nurse Practitioner | 6901 S 84th St, La Vista, NE 68128-2127 | 2019-10-08 |
| 1932763067 | Jennifer Poots | Pharmacist | 6901 S 84th St, La Vista, NE 68128-2127 | 2019-04-24 |
| 1437636552 | Rachel Stutheit | Nurse Practitioner | 6901 S 84th St, La Vista, NE 68128-2127 | 2018-07-21 |
| 1356757728 | Jill Marie Brown | Nurse Practitioner | 6901 S 84th St, La Vista, NE 68128-2127 | 2014-07-07 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922589746 | Ruth Ann Moses | Prevention Professional | 7030 S 110th St, Omaha, NE 68128 | 2018-08-29 |
| 1972945897 | Jenna Leigh Graeve | Physical Therapist | 7040 S 114th St Plz Apt 203, La Vista, NE 68128 | 2013-07-19 |
| 1245564012 | Optum Infusion Services 302, LLC | Pharmacy | 8720 South 114th Street, Suite 106, La Vista, NE 68128 | 2009-09-28 |
| 1730385709 | Granville Assisted Living, LLC | Point of Service | 5807 Granville Parkway, La Vista, NE 68128 | 2007-06-26 |
| 1629160072 | Rachel L. Mccann | Pediatrics | 9801 Giles Road, Suite 1, La Vista, NE 68128 | 2006-09-29 |
| 1730118233 | Donald R Krysl | Optometrist | 8102 S 84th St, Lavista, NE 68128 | 2006-06-30 |
| 1518312719 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 12515 Portside Pkwy, La Vista, NE 68128 | 2016-04-26 |
| 1245685445 | Costco Wholesale Corporation | Hearing Aid Equipment | 12515 Portside Pkwy, La Vista, NE 68128 | 2016-04-26 |
| 1386011971 | Kelsey Klatt | Occupational Therapist | 6960 S 110th St, La Vista, NE 68128 | 2015-08-31 |
| 1003299827 | Jordan Tichenor | Internal Medicine | 8604 Giles Rd, La Vista, NE 68128 | 2015-06-30 |
| Find all providers in zip 68128 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457993750 | Fredericka Jackson | Nurse Practitioner | 6901 S 84th St, La Vista, NE 68128-2127 | 2019-10-08 |
| 1437636552 | Rachel Stutheit | Nurse Practitioner | 6901 S 84th St, La Vista, NE 68128-2127 | 2018-07-21 |
| 1356757728 | Jill Marie Brown | Nurse Practitioner | 6901 S 84th St, La Vista, NE 68128-2127 | 2014-07-07 |
| 1497008825 | Cheryl Darby-carlberg | Nurse Practitioner | 6901 S 84th St, La Vista, NE 68128-2127 | 2012-10-23 |
| 1790917854 | Angela Marie Gilfillan | Nurse Practitioner | 8248 S 96th St, La Vista, NE 68128 | 2009-08-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508465048 | Lisa J Lehr | Nurse Practitioner | 6336 John J Pershing Dr Fl Lozier2, Omaha, NE 68110-1100 | 2020-10-24 |
| 1154929230 | Chelsea Lynae Jones | Nurse Practitioner | 75 Highway 77, Winnebago, NE 68071-5001 | 2020-10-12 |
| 1144837899 | Kristine Ellen Follett | Nurse Practitioner | 5900 Spruce St, Lincoln, NE 68516-1425 | 2020-09-27 |
| 1629683719 | Jessica Leigh Queen | Nurse Practitioner | 6818 N 102nd Avenue Cir, Omaha, NE 68122-3009 | 2020-09-15 |
| 1023623451 | Kayla Hallock | Nurse Practitioner | 3740 N 27th St Ste 1, Lincoln, NE 68521-4162 | 2020-09-11 |
| 1598379844 | Austin Keith Gydesen | Nurse Practitioner | 1022 Pacific St, Cambridge, NE 69022-3517 | 2020-09-03 |
| 1255944930 | Taylor Marjorie Feilmeier | Nurse Practitioner | 56338 881 Rd, Hartington, NE 68739-4021 | 2020-08-24 |
| 1639780414 | Nicolette R Lovitt | Nurse Practitioner | 14721 Stone Ave, Omaha, NE 68116-4323 | 2020-08-13 |
| 1376153197 | Matilda R Beaudette | Nurse Practitioner | 11108 Hilltop Ave, Omaha, NE 68164-2273 | 2020-08-06 |
| 1508476847 | Deann Marie Mcclellan | Nurse Practitioner | 22625 130th Rd, Riverdale, NE 68870-7105 | 2020-08-02 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.