WATER CITY CARE MISSION, INC. (NPI# 1154929909) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1154929909 |
Entity Type | Organization |
Organization Name | WATER CITY CARE MISSION, INC. |
Practice Address |
449 High Ave. Oshkosh WI 54901-4708 |
Practice Telephone | 9202346970 |
Practice Fax Number | 9207442488 |
Mailing Telephone | 9202346970 |
Mailing Fax Number | 9207442488 |
Enumeration Date | 2020-10-14 |
Last Update Date | 2020-10-14 |
Authorized Official Name | DR. BRIANNA M. KLOTZ (DIRECTOR) |
Authorized Official Telephone | 9202346970 |
Authorized Official Credential | APNP |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 111N00000X | Chiropractor | Chiropractic Providers | ||
N | 367A00000X | Advanced Practice Midwife | Physician Assistants & Advanced Practice Nursing Providers | ||
Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers |
Other Name | Type Code |
---|---|
St. Anne's Clinic | Doing Business As Name - Organization |
Street Address |
449 HIGH AVE. |
City | OSHKOSH |
State | WI |
Zip Code | 54901-4708 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1023657855 | Kayla Crockett | Specialist/Technologist | Kolf Sports Center, Oshkosh, WI 54901 | 2019-12-26 |
1629593421 | Taymoor Sardar | Psychologist | 404 N. Main St., Suite 501, Oshkosh, WI 54901 | 2017-08-14 |
1821414889 | Chris Lynn Wiggs | Registered Nurse | 2150 Ontario St., Oshkosh, WI 54901 | 2014-03-13 |
1114359023 | Robert James Rigoni Jr. | Pharmacist | 1300 S. Koeller Rd, Oshkosh, WI 54901 | 2013-08-01 |
1427313386 | Scott Forrest Trippe | Psychologist | 627 Bayshore Drive, Oshkosh, WI 54901 | 2012-07-06 |
1003113135 | Ashley Lauren Procknow | Registered Nurse | 105 Bowen St, Oshkosh, WI 54901 | 2011-02-25 |
1982915963 | Benjamin Ross Goldstein | Psychiatry & Neurology | 4100 Treffert Dr., Oshkosh, WI 54901 | 2010-06-24 |
1982926234 | Patricia A Pendowski | Counselor | 3240 Jackson Street, Oshkosh, WI 54901 | 2010-02-26 |
1083867477 | Lori Marie Pierquet | Psychologist | 375 C Executive Suites, City Center, Oshkosh, WI 54901 | 2008-10-29 |
1346493228 | William Alexander Hammond | Dentist | 5252 I-ah-maytah Rd., Oshkosh, WI 54901 | 2008-10-23 |
Find all providers in zip 54901 |
Taxonomy Code | 363LF0000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Family |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1629683065 | Yia Lor | Nurse Practitioner | 3750 Summerset Way Apt 1, Oshkosh, WI 54901-0501 | 2020-09-11 |
1033670088 | Jennifer Krueger | Nurse Practitioner | 1304 Tammy Rd, Oshkosh, WI 54904-9310 | 2019-03-30 |
1457822058 | John Concepcion | Nurse Practitioner | 4485 Ravine Way, Oshkosh, WI 54904-7150 | 2018-12-08 |
1750479820 | Mary K Friess | Nurse Practitioner | 500 Algoma Blvd, Uw Oshkosh - College of Nursing, Oshkosh, WI 54901 | 2006-10-11 |
1346335734 | Jill M Collier | Nurse Practitioner | 2310 Westowne Ave, Oshkosh, WI 54904-7778 | 2006-10-03 |
1154947851 | Kristian Noelle Bastress | Nurse Practitioner | 1855 S Koeller St, Oshkosh, WI 54902-6186 | 2020-06-19 |
1629547633 | Tosha Wright | Nurse Practitioner | 2700 W 9th Ave, Oshkosh, WI 54904-7247 | 2018-11-19 |
1881197028 | Angela Marie Beach | Nurse Practitioner | 1855 S Koeller St, Oshkosh, WI 54902-6186 | 2018-03-14 |
1518340090 | Ruth Staszak | Nurse Practitioner | 1855 S Koeller St, Oshkosh, WI 54902-6186 | 2015-07-02 |
1528460839 | Kristi Ziolkowski | Nurse Practitioner | 777 Algoma Blvd, Radford Hall, Student Health Center, Oshkosh, WI 54901-3534 | 2014-09-17 |
Find all providers in OSHKOSH |
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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.