MARY COLLEEN WAHL (NPI# 1508370495) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508370495 |
| Entity Type | Individual |
| Full Name | MARY COLLEEN WAHL |
| Credential | ARNP, DNP |
| Practice Address |
4455 Sam Mitchell Dr Chipley FL 32428-3501 |
| Mailing Address |
532 Greenbay Rd Chipley FL 32428 |
| Practice Telephone | 8507730392 |
| Mailing Telephone | 8506584924 |
| Enumeration Date | 2017-11-30 |
| Last Update Date | 2017-11-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
ARNP2925992 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750890257 | Mary Wahl | Case Manager/Care Coordinator | 3445 Post Rd, Warwick, RI 02886-7147 | 2017-09-27 |
| 1194781278 | Mary E Wahl | Internal Medicine | 303 Nicollet Blvd, Burnsville, MN 55337 | 2006-04-26 |
| 1558343111 | Mary Claire Wahl | Advanced Practice Midwife | 4102 Pinion Dr, Usaf Academy, CO 80840-2502 | 2005-11-18 |
| Street Address |
4455 SAM MITCHELL DR |
| City | CHIPLEY |
| State | FL |
| Zip Code | 32428-3501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871798256 | Aileen M Cordero | General Practice | 4455 Sam Mitchell Dr, Chipley, FL 32428-3501 | 2007-06-18 |
| 1972065902 | Stephen Caz Wester | Registered Nurse | 4455 Sam Mitchell Dr, Chipley, FL 32428-3501 | 2019-03-31 |
| 1649740002 | Haley Nicole Wentowski | Psychologist | 4455 Sam Mitchell Dr, Chipley, FL 32428-3501 | 2018-11-28 |
| 1407309867 | Doris M Roberts | Nurse Practitioner | 4455 Sam Mitchell Dr, Chipley, FL 32428 | 2016-08-02 |
| 1326318908 | Norma B Gilo | Family Medicine | 4455 Sam Mitchell Dr, Chipley, FL 32428-3501 | 2012-01-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245590918 | Restore Therapy and Wellness, Inc. | Clinic/Center | 877 Third Street, Suite 1, Chipley, FL 32428 | 2012-05-29 |
| 1851470827 | Washington County School Board | Local Education Agency (LEA) | 652 3rd Street, Chipley, FL 32428 | 2006-11-02 |
| 1578659769 | Arthur Clayton Zediker | Dentist | 5016 Pine Ridge Dr, Chipley, FL 32428 | 2006-10-05 |
| 1528159480 | Teresa Lynn Seay | Nurse Practitioner | 1351 South Blvd, Chipley, FL 32428 | 2006-09-27 |
| 1386753044 | Jack Rogers Taylor | Dentist | 843 Hwy 277, Chipley, FL 32428 | 2006-08-29 |
| 1992818447 | William Edwin Cox IIi | Dentist | 699 2nd St, Chipley, FL 32428 | 2006-08-17 |
| 1255319695 | Samuel E Ward Md Pl | Family Medicine | 1410 Brickyard Rd, Chipley, FL 32428 | 2006-01-05 |
| 1114017548 | Robert W Snare Md Pa | General Practice | 1187 Main St, Ste 3, Chipley, FL 32428 | 2006-10-14 |
| 1124117809 | Belinda Gail Parker Mcrae | Nurse Practitioner | 1410 Brickyard Rd, Samuel E Ward Md Pl, Chipley, FL 32428 | 2006-10-12 |
| 1003907957 | Lori Dawn Edenfield | Nurse Practitioner | 1410 Brickyard Rd, Samuel E Ward Md Pl, Chipley, FL 32428 | 2006-09-27 |
| Find all providers in zip 32428 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871193292 | Paulette Vital-herne | Nurse Practitioner | 4449 Old Highway 41 S, Sun City, FL 33586-9700 | 2020-10-26 |
| 1144828104 | Shilpa Narahari Reddy | Nurse Practitioner | 19435 N Coquina Way, Weston, FL 33332-2417 | 2020-10-13 |
| 1023615440 | Bridget Mary Rossi | Nurse Practitioner | 1536 Alford Street, Unit 5, Jacksonville, FL 32207-3220 | 2020-10-08 |
| 1154928612 | Haili Harless | Nurse Practitioner | 3961 23rd Ave N, Saint Petersburg, FL 33713-4850 | 2020-10-07 |
| 1679170674 | Lorena Beatriz Canelon | Nurse Practitioner | 16151 Sw 147th Ln, Miami, FL 33196-6416 | 2020-10-04 |
| 1851998082 | Sanon Edmond | Nurse Practitioner | 5236 Arbor Glen Cir, Lake Worth, FL 33463-8066 | 2020-10-01 |
| 1710594114 | Sumelia Waddell | Nurse Practitioner | 462 Ne 210th Circle Ter Apt 204, Miami, FL 33179-5236 | 2020-09-29 |
| 1780291526 | Ilmary De Los Angeles Jimenez | Nurse Practitioner | 7909 Biltmore Blvd, Miramar, FL 33023-5829 | 2020-09-25 |
| 1972119535 | Dennis Carmelo Cadiz Serfino | Nurse Practitioner | 1960 Willesdon Dr E, Jacksonville, FL 32246-0694 | 2020-09-18 |
| 1760097745 | Amanee Orra | Nurse Practitioner | 3982 Bee Ridge Rd Ste H-a, Sarasota, FL 34233-1211 | 2020-09-15 |
| Find all providers with the same taxonomy | ||||
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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.