MRS. JACKI L WILDEMAN


Address: 4007 Gateway Blvd # 100, Newburgh, IN 47630-8947
Phone: 8128420907

MRS. JACKI L WILDEMAN (NPI# 1184672628) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1184672628
Entity Type Individual
Full Name MRS. JACKI L WILDEMAN
Credential ARNP
Practice Address 4007 Gateway Blvd # 100
Newburgh
IN 47630-8947
Mailing Address 4015 Gateway Blvd Ste 2120
Newburgh
IN 47630-9460
Practice Telephone 8128420907
Practice Fax Number 8124907054
Mailing Telephone 8128420907
Mailing Fax Number 8124644485
Enumeration Date 2006-05-05
Last Update Date 2019-12-06
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363L00000X Nurse Practitioner 71001467A IN Physician Assistants & Advanced Practice Nursing Providers
N 363LA2100X Nurse Practitioner
Specialization: Acute Care
71001467A IN Physician Assistants & Advanced Practice Nursing Providers
N 363LA2100X Nurse Practitioner
Specialization: Acute Care
309002150 IL Physician Assistants & Advanced Practice Nursing Providers
N 363LA2100X Nurse Practitioner
Specialization: Acute Care
3899P KY Physician Assistants & Advanced Practice Nursing Providers
N 363LA2100X Nurse Practitioner
Specialization: Acute Care
28079891A IN Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
IN 200427140 05
ANTHEM 000000270530 01
KY 78009586 05

Office Location

Street Address 4007 GATEWAY BLVD # 100
City NEWBURGH
State IN
Zip Code 47630-8947

Providers in the same location

NPI Name Taxonomy Address Enumeration
1043469471 Maruthi Srikanth Penumetsa Internal Medicine 4007 Gateway Blvd # 100, Newburgh, IN 47630-8947 2008-09-10

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1477199859 Dana Marie Deken Physical Therapy Assistant 322 Bell Oaks, Newburgh, IN 47630 2019-11-21
1851948897 Riley Elizabeth Eilken Physical Therapist 4233 Gateway Glbd, Suite 201, Newburgh, IN 47630 2019-08-23
1851851174 Jennifer Ozete Cole Physical Therapist 4233 Gateway Boulvard Suite 201, Newburgh, IN 47630 2019-03-22
1174014542 Katherine E Lyle Music Therapist 1003 Sr 662 W, Newburgh, IN 47630 2018-05-22
1144719923 Jennifer Michelle Huffman Occupational Therapy Assistant 9800 Lincolne Avenue, Newburgh, IN 47630 2018-05-07
1215431846 Deaconess Specialty Physicians, Inc Internal Medicine 4007 Gateway Blvd Ste 100, Newburgh, IN 47630 2018-03-20
1801313002 Deaconess Hospital, Inc Pharmacy 4209 Gateway Blvd., Newburgh, IN 47630 2017-08-28
1629435599 Caitlyn Beckinger Physical Therapy Assistant 9800 Lincoln Ave, Newburgh, IN 47630 2016-01-24
1568869410 Jill Buck Social Worker 8788 Ruffian Ln Ste D, Newburgh, IN 47630 2014-11-20
1003191057 Marshall Alan Cox Pharmacist 7769 Hwy 66, Newburgh, IN 47630 2011-10-20
Find all providers in zip 47630

Taxonomy Information

Taxonomy Code 363L00000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner

Taxonomy Definition

(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.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1356604268 Sara K Dillon Nurse Practitioner 4133 Gateway Blvd Ste 220, Newburgh, IN 47630-7918 2012-06-18
1154577609 Deaconess Hospital, Inc Nurse Practitioner 10455 Orthopaedic Drive, Newburgh, IN 47630 2008-08-15
1962665588 Deaconess Hospital Inc Nurse Practitioner 4107 Gateway Blvd, Newburgh, IN 47630-8954 2008-07-03
1467622084 Deirdre Mae Micker Nurse Practitioner 9 Hdsn Vly Prof Plz, Newburgh, NY 12550-3150 2008-03-11
1568630127 Eric L Glines Nurse Practitioner 4015 Gateway Blvd Ste 2120, Newburgh, IN 47630-9460 2008-02-18
1154514941 Darla Speigner Nurse Practitioner 100 St Marys Epworth Xing Ste B100, Newburgh, IN 47630-9161 2007-08-24
1316915978 Karen R Brossman Bass Nurse Practitioner 8599 High Pointe Dr, Newburgh, IN 47630 2006-03-09
1598767915 Susan Denise Mcdowell Nurse Practitioner 4133 Gateway Blvd, Suite 220, Newburgh, IN 47630-7953 2005-08-15
1487266326 Tarah Bracher Nurse Practitioner 4133 Gateway Blvd Ste 290, Newburgh, IN 47630-7918 2020-08-21
1275145369 Amy Sullivan Nurse Practitioner 4011 Gateway Blvd, Newburgh, IN 47630-8947 2020-08-19
Find all providers in NEWBURGH

Competitor

Search similar providers

City NEWBURGH
Zip Code 47630

Improve Information

Please comment or provide details below to improve the information on MRS. JACKI L WILDEMAN.

Dataset Information

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.

Trending Searches