CONNIE LEE WORM (NPI# 1104044395) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104044395 |
| Entity Type | Individual |
| Full Name | CONNIE LEE WORM |
| Practice Address |
2108 Kohler Memorial Dr Sheboygan WI 53081-3100 |
| Mailing Address |
3532 N 21st St Sheboygan WI 53083-2807 |
| Practice Telephone | 9204589401 |
| Practice Fax Number | 9204588801 |
| Mailing Telephone | 9204586556 |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 86329-030 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2108 KOHLER MEMORIAL DR |
| City | SHEBOYGAN |
| State | WI |
| Zip Code | 53081-3100 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104297316 | St. Vincent Hospital-hospital Sisters-third Order of St. Francis | Clinic/Center | 2108 Kohler Memorial Dr, Sheboygan, WI 53081-3100 | 2015-10-14 |
| 1790117703 | Lauren B Wingender | Nurse Practitioner | 2108 Kohler Memorial Dr, Sheboygan, WI 53081-3100 | 2013-07-31 |
| 1578814422 | Grube Anesthesia Services, LLC | Nurse Anesthetist, Certified Registered | 2108 Kohler Memorial Dr, Ste 101, Sheboygan, WI 53081-3100 | 2012-10-01 |
| 1578737136 | Planned Parenthood of Wisconsin | Non-Pharmacy Dispensing Site | 2108 Kohler Memorial Dr, Sheboygan, WI 53081-3100 | 2008-04-15 |
| 1245414374 | St. Joseph's Hospital | Special Hospital | 2108 Kohler Memorial Dr, Sheboygan, WI 53081-3100 | 2007-12-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770053696 | Kathy Hughes Counseling, LLC | Community/Behavioral Health | 630 Riverfront Dr Ste 203, Sheboygan, WI 53081 | 2018-12-04 |
| 1780159004 | Great Lakes Clinic and Consultants, LLC | Clinic/Center | 1407 North 8th Street, Suite 203, Sheboygan, WI 53081 | 2018-10-13 |
| 1174032106 | Laura Elizabeth Manning | Registered Nurse | 325 Linocln Ave, Sheboygan, WI 53081 | 2017-09-21 |
| 1043733686 | Chasidy D Wilke | Behavioral Analyst | 2223 Terrace View Dr Apt 3a, Sheboygan, WI 53081 | 2017-07-25 |
| 1700320074 | Darlene Wilken | Counselor | 2842 S. Business Dr, Sheboygan, WI 53081 | 2016-12-06 |
| 1942652185 | Jacob Steven Son | Dentist | 3555 Wasington Ave., Sheboygan, WI 53081 | 2016-07-12 |
| 1225491749 | Cassandra Lea Loehndorf | Social Worker | 3321 S. 12th St., Sheboygan, WI 53081 | 2016-04-01 |
| 1003201112 | Jason Meinhardt | Dentist | 2115 S Memorial Pl, Sheboygan, WI 53081 | 2015-04-06 |
| 1346634110 | Christopher Lenz | Specialist/Technologist | 2920 Superior Ave., Prevea Orthopedics, Sheboygan, WI 53081 | 2015-03-19 |
| 1780008060 | James Simac | Counselor | 503 Wisconsin Ave., Sheboygan, WI 53081 | 2014-02-07 |
| Find all providers in zip 53081 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235252339 | Annette Vonfrankenberg | Nurse Practitioner | 924 N Taylor Dr, Sheboygan, WI 53081-4202 | 2007-04-06 |
| 1316073836 | Karen S Lim | Nurse Practitioner | 1721 Saemann Ave, Sheboygan, WI 53081 | 2007-02-26 |
| 1922636877 | Kelly Lauren Leist | Nurse Practitioner | 1902 Mead Ave, Sheboygan, WI 53081-6140 | 2020-03-27 |
| 1154961050 | Stephanie L Holschbach | Nurse Practitioner | 2414 Kohler Memorial Dr, Sheboygan, WI 53081-3129 | 2020-01-09 |
| 1568017424 | John Hernandez | Nurse Practitioner | 1721 Saemann Ave, Sheboygan, WI 53081-2342 | 2019-08-07 |
| 1962064436 | Courtney F Klatt | Nurse Practitioner | 1902 Mead Ave, Sheboygan, WI 53081-6140 | 2019-07-03 |
| 1891259917 | Debra A Wollert | Nurse Practitioner | 3711 S Taylor Dr, Sheboygan, WI 53081-8495 | 2019-01-23 |
| 1386180362 | Amy Sue Gumieny | Nurse Practitioner | 1411 N Taylor Dr, Sheboygan, WI 53081-3043 | 2017-01-13 |
| 1508319344 | Allison Schmitt | Nurse Practitioner | 2629 N 7th St, Sheboygan, WI 53083-4932 | 2016-07-28 |
| 1568915650 | Julie A Reichle | Nurse Practitioner | 2629 N 7th St, Sheboygan, WI 53083-4932 | 2016-07-26 |
| Find all providers in SHEBOYGAN | ||||
Please comment or provide details below to improve the information on CONNIE LEE WORM.
| 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.