PHYLLIS C WIENER (NPI# 1548230196) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548230196 |
| Entity Type | Individual |
| Full Name | PHYLLIS C WIENER |
| Credential | WHCNP |
| Practice Address |
1200 Lagoon Ave Minneapolis MN 55408-2077 |
| Mailing Address |
4028 Elliot Ave Minneapolis MN 55407-3147 |
| Practice Telephone | 6128236300 |
| Mailing Telephone | 6128221548 |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LW0102X |
Nurse Practitioner Specialization: Women's Health |
R1017050 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | BCBS MN | 5K166WI | 01 |
| SIOUX VALLEY HEALTH PLAN | 28721 | 01 | |
| HEALTH PARTNERS | HP17896 | 01 | |
| MEDICA | 07-14658 | 01 | |
| PREFERRED ONE | 1017710 | 01 | |
| AMERICA'S PPO (ARAZ) | 1075705 | 01 | |
| UCARE | 142730 | 01 |
| Street Address |
1200 LAGOON AVE |
| City | MINNEAPOLIS |
| State | MN |
| Zip Code | 55408-2077 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164401527 | Planned Parenthood Minnesota, North Dakota, South Dakota | Specialist | 1200 Lagoon Ave, Minneapolis, MN 55408-2077 | 2006-01-13 |
| 1023564150 | Melissa Lee Jones | Nurse Practitioner | 1200 Lagoon Ave, Minneapolis, MN 55408-2077 | 2016-08-29 |
| 1750759502 | Courtney Kiesow | Nurse Practitioner | 1200 Lagoon Ave, Minneapolis, MN 55408-2077 | 2015-09-10 |
| 1245461441 | Jessica Thane Zaldivar | Nurse Practitioner | 1200 Lagoon Ave, Minneapolis, MN 55408-2077 | 2009-08-05 |
| 1821065723 | Carol Elizabeth Ball | Obstetrics & Gynecology | 1200 Lagoon Ave, Minneapolis, MN 55408-2077 | 2006-03-01 |
| 1992776900 | Marta Tochacek | General Practice | 1200 Lagoon Ave, Minneapolis, MN 55408-2077 | 2006-01-28 |
| 1528038106 | Amy S Lange | Advanced Practice Midwife | 1200 Lagoon Ave, Minneapolis, MN 55408-2077 | 2006-01-25 |
| 1003886722 | Pamela S.f. Glenn | Advanced Practice Midwife | 1200 Lagoon Ave, Minneapolis, MN 55408-2077 | 2006-01-25 |
| 1063482933 | Beth K Bennington | Nurse Practitioner | 1200 Lagoon Ave, Minneapolis, MN 55408-2077 | 2006-01-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548870512 | Community Solutions Services Inc | Counselor | 3043 2nd Ave South, Suite 101, Minneapolis, MN 55408 | 2020-08-05 |
| 1356962740 | Mohammad Mushtaq Khandwala | Student in an Organized Health Care Education/Training Program | 2810 Nicollet Avenue South, Minneapolis, MN 55408 | 2020-04-27 |
| 1861012700 | Open Arms Group Home LLC | Nursing Care | 1 W Lake St Suite 165 Unit 7, Minneapolis, MN 55408 | 2020-04-21 |
| 1538710413 | Yuejuan Bian | Acupuncturist | 2743 Lyndale Ave S, Suite 2, Minneapolis, MN 55408 | 2019-09-23 |
| 1710536081 | Blu Care Inc | Clinic/Center | 2910 Pillsbury Ave S Ste 338, Minneapolis, MN 55408 | 2019-09-09 |
| 1417510165 | Kau Macador Queeglay | Counselor | 621 West Lake Street Suite 350 Lynlake Building, Minneapolis, MN 55408 | 2019-04-18 |
| 1346735875 | Nicole S Ehrenberg | Social Worker | 324 E 35th Street, Minneapolis, MN 55408 | 2018-06-27 |
| 1639681612 | American Family Transportation Inc | Non-emergency Medical Transport (VAN) | 2910 Pillsbury Ave So Suite 434, Minneapolis, MN 55408 | 2017-10-30 |
| 1285181743 | Multilingual Word Inc | Interpreter | 1431 W 32nd St, Minneapolis, MN 55408 | 2016-09-01 |
| 1376906388 | Sama Healthcare | Family Medicine | 2639 Nicollet Ave., Suite 130, Minneapolis, MN 55408 | 2016-03-29 |
| Find all providers in zip 55408 | ||||
| Taxonomy Code | 363LW0102X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Women's Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326519646 | Kelsey M Thompson | Nurse Practitioner | 2920 Aldrich Ave S Apt 145, Minneapolis, MN 55408-4275 | 2018-12-13 |
| 1366842734 | Meghan Stommes | Nurse Practitioner | 801 Nicollet Mall Ste 400, Minneapolis, MN 55402-2520 | 2014-09-03 |
| 1831328756 | Health Empowerment Institute | Nurse Practitioner | 2512 W Broadway Ave, Minneapolis, MN 55411-1737 | 2009-07-13 |
| 1174692305 | Sandra Lee-hoefs Anderson | Nurse Practitioner | 33 S 5th St, Suite 400, Minneapolis, MN 55402-1050 | 2006-11-06 |
| 1285607390 | Jennifer Elizabeth Smith-otte | Nurse Practitioner | 121 S 8th St, Suite 600, Minneapolis, MN 55402-2841 | 2006-02-09 |
| 1013987957 | Kristine M Alswager | Nurse Practitioner | 121 E 8th St, Minneapolis, MN 55402 | 2006-01-24 |
| 1396395224 | Ann Marie Marshall | Nurse Practitioner | 918 W Lake St, Minneapolis, MN 55408-2857 | 2019-09-12 |
| 1932646528 | Alison Michelle Kadletz | Nurse Practitioner | 2800 Chicago Ave, Minneapolis, MN 55407-1318 | 2017-01-20 |
| 1023564150 | Melissa Lee Jones | Nurse Practitioner | 1200 Lagoon Ave, Minneapolis, MN 55408-2077 | 2016-08-29 |
| 1174976138 | Stephanie Lynn Delkoski | Nurse Practitioner | 606 24th Ave S, #300, Minneapolis, MN 55454-1455 | 2016-07-14 |
| Find all providers in MINNEAPOLIS | ||||
| City | MINNEAPOLIS |
| Zip Code | 55408 |
Please comment or provide details below to improve the information on PHYLLIS C WIENER.
| 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.