MEDICARE: KAI WENTZ PMHNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	43758	WY

General Provider Information

NPI Number	:	1255116059
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAI WENTZ PMHNP

Provider Business Mailing Address
First Line	:	PO BOX 51811
Second Line	:
City	:	CASPER
State	:	WY
Zip	:	82605-1811
Country	:	US
Telephone Number	:	307-251-7220
Fax Number	:	307-333-0342

Provider Business Practice Location Address
First Line	:	800 WERNER CT # 325
Second Line	:
City	:	CASPER
State	:	WY
Zip	:	82601-1326
Country	:	US
Telephone Number	:	307-251-7220
Fax Number	:	307-333-0342

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/29/2023
Last Update Date	:	03/26/2026

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