MEDICARE: MS. KIMBERLY ANN WOHLWEND APRN, PMHNP-BC

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	363LF0000X	Family Nurse Practitioner	111644	NE
2	163W00000X	Registered Nurse	77368	NE
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	111644	NE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1821989310	OTHER	NE	NPI 2

General Provider Information

NPI Number	:	1952650608
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KIMBERLY ANN WOHLWEND APRN, PMHNP-BC

Provider Business Mailing Address
First Line	:	7427 CASTLE ST
Second Line	:
City	:	PAPILLION
State	:	NE
Zip	:	68046-4716
Country	:	US
Telephone Number	:	402-578-3950
Fax Number	:

Provider Business Practice Location Address
First Line	:	131 N WASHINGTON ST STE A
Second Line	:
City	:	PAPILLION
State	:	NE
Zip	:	68046-2434
Country	:	US
Telephone Number	:	531-217-5257
Fax Number	:	949-864-3749

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

Provider Enumeration Date	:	09/09/2012
Last Update Date	:	05/20/2026

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