MARY ANN WIETBROCK (NPI# 1336551175) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336551175 |
| Entity Type | Individual |
| Full Name | MARY ANN WIETBROCK |
| Credential | RN MSN CNS |
| Practice Address |
4108 W 400 S New Palestine IN 46163-9612 |
| Practice Telephone | 3174109140 |
| Mailing Telephone | 3174109140 |
| Enumeration Date | 2014-05-28 |
| Last Update Date | 2014-05-28 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 364SC1501X |
Clinical Nurse Specialist Specialization: Community Health/Public Health |
28088637A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4108 W 400 S |
| City | NEW PALESTINE |
| State | IN |
| Zip Code | 46163-9612 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659780708 | Cardinal Elements Inc | Registered Nurse | 4108 W 400 S, New Palestine, IN 46163-9612 | 2014-08-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851657217 | Robert Philip Romano | Pharmacist | 2461 S Wildflower Lane, New Palestine, IN 46163 | 2012-04-10 |
| 1811022106 | Angela Dawn Marrow | Physical Therapy Assistant | 4919 W 1120 N, Newpalestine, IN 46163 | 2007-02-23 |
| 1588733596 | Sharon Paluga-staggs | Dentist | 4037 S Arbor Lane, New Palestine, IN 46163 | 2006-11-06 |
| 1669575387 | Hook Superx LLC | Pharmacy | 5026 West Us 52, New Palestine, IN 46163 | 2006-09-07 |
| 1508970575 | Community Hospitals of Indiana | Pediatrics | 4037 S. Arbor Lane, Suite D, New Palestine, IN 46163 | 2006-08-18 |
| 1740224401 | Connie Jo Gambrel | Registered Nurse | 3924 S Village Drive, New Palestine, IN 46163 | 2006-06-15 |
| 1265979108 | Chanel Herbertz | Nurse Practitioner | 5026 W Us 52, New Palestine, IN 46163 | 2017-01-30 |
| 1124463534 | Hoosier Hear Gear, LLC | Clinic/Center | 6375 W Us 52, New Palestine, IN 46163 | 2013-04-30 |
| 1376727578 | Heather Lynn Campbell | Specialist/Technologist | 1 School Street, New Palestine, IN 46163 | 2007-12-24 |
| 1538239447 | Sharon Paluga-staggs D.d.s., P.C. | Dentist | 4037 S Arbor Lane, New Palestine, IN 46163 | 2006-11-08 |
| Find all providers in zip 46163 | ||||
| Taxonomy Code | 364SC1501X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Community Health/Public Health |
| Definition to come... |
| City | NEW PALESTINE |
| Zip Code | 46163 |
Please comment or provide details below to improve the information on MARY ANN WIETBROCK.
| 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.