MICHELLE WIEDENHOEFT (NPI# 1326033085) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326033085 |
| Entity Type | Individual |
| Full Name | MICHELLE WIEDENHOEFT |
| Credential | APRN |
| Practice Address |
3661 S Babcock St 2nd Floor Melbourne FL 32901-8205 |
| Mailing Address |
3300 S Fiske Blvd Rockledge FL 32955-4306 |
| Practice Telephone | 3218684120 |
| Practice Fax Number | 3218684135 |
| Enumeration Date | 2005-09-19 |
| Last Update Date | 2020-03-16 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
APRN131609 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | MEDICARE | HG280Y | 01 |
| FL | 008990900 | 05 |
| Street Address |
3661 S BABCOCK ST 2ND FLOOR |
| City | MELBOURNE |
| State | FL |
| Zip Code | 32901-8205 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639593643 | Jennifer Paranhos | Social Worker | 3661 S Babcock St, 2nd Floor, Melbourne, FL 32901-8205 | 2014-02-11 |
| 1104852250 | Roberta L Krance | Nurse Practitioner | 3661 S Babcock St, Suite 105, Melbourne, FL 32901-8205 | 2006-06-23 |
| 1760478796 | Visalakshi Srinivasan | Family Medicine | 3661 S Babcock St, 2nd Floor, Melbourne, FL 32901-8903 | 2005-09-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467062943 | George Pappas | Anesthesiologist Assistant | 1775 W. Hibiscus Blvd., Ste 215, Melbourne, FL 32901 | 2020-08-09 |
| 1124676820 | Abbi Dell Lee | Behavioral Analyst | 3251 Engineering St, Melbourne, FL 32901 | 2019-08-27 |
| 1750856878 | Jeffrey Michael Cavanagh | Behavior Technician | 3251 Engineering Street, Melbourne, FL 32901 | 2018-10-04 |
| 1740766021 | Amanda Miller | Behavior Technician | 1885 W Hibiscus Blvd, Melbourne, FL 32901 | 2018-07-19 |
| 1396244406 | Dragen II LLC | Urology | 129 W Hibiscus Blvd Ste D, Melbourne, FL 32901 | 2018-02-03 |
| 1225550692 | Cabrit Psychotherapy Services LLC | Marriage & Family Therapist | 100 Rialto Place, Suite 700, Melbourne, FL 32901 | 2017-07-07 |
| 1487188058 | Project Response, Inc. | Clinic/Center | 747 S. Apollo Boulevard, Melbourne, FL 32901 | 2017-04-20 |
| 1184174575 | Paulette Swanson | Physical Therapist | 611 East Sheridan Rd, Melbourne, FL 32901 | 2016-10-10 |
| 1841747839 | Nicholas Wilson | Social Worker | 3661 S. Babcock St., Melbourne, FL 32901 | 2016-09-07 |
| 1467804278 | Nickolas Hetherington | Occupational Therapist | 1900 S Harbor City Blvd Ste 108, Melbourne, FL 32901 | 2016-07-05 |
| Find all providers in zip 32901 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316475171 | Jacqueline Hoskins | Nurse Practitioner | 2644 Kingsmill Ave, Melbourne, FL 32934-7583 | 2017-05-24 |
| 1255773701 | Mobile Physicians Group Inc | Nurse Practitioner | 1010 E New Haven Ave Ste B, Melbourne, FL 32901 | 2013-07-25 |
| 1598100893 | Serina Wisnewski | Nurse Practitioner | 2955 Pineda Plaza Way, Suite: 115, Melbourne, FL 32940-7318 | 2013-05-01 |
| 1841521176 | Leonora Lillian Conte | Nurse Practitioner | 325 Tangle Run Blvd Apt 1112, Melbourne, FL 32940-1831 | 2010-01-27 |
| 1407073943 | Paige Michelle Ahammer | Nurse Practitioner | 221 W Hibiscus Blvd, Suite 401, Melbourne, FL 32901-3044 | 2007-04-19 |
| 1861491565 | Marva Edwards-marshall | Nurse Practitioner | 720 E New Haven Ave, Melbourne, FL 32901-5474 | 2005-07-15 |
| 1801891585 | Bruce Robert Simpkins | Nurse Practitioner | 3661 S Babcock St Fl 2, Melbourne, FL 32901-8205 | 2005-06-17 |
| 1053922476 | Cory Louis Nayfield | Nurse Practitioner | 2200 W Eau Gallie Blvd Ste 200, Melbourne, FL 32935-3166 | 2020-08-10 |
| 1457830556 | Heidi Jo Sommers | Nurse Practitioner | 1131 W New Haven Ave, Melbourne, FL 32904-4110 | 2018-08-09 |
| 1558872606 | Julie Ann Starr | Nurse Practitioner | 8247 Devereux Dr Ste 102, Melbourne, FL 32940-8227 | 2017-10-17 |
| Find all providers in MELBOURNE | ||||
Please comment or provide details below to improve the information on MICHELLE WIEDENHOEFT.
| 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.