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NPI Code Detail

MEDICARE: WENDE A MOLINE APRN-BC

MEDICARE:   WENDE A MOLINE  APRN-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
1363L00000XNurse Practitioner26598SC
2363L00000XNurse Practitioner658-033WI

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00989263OTHERWIRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1457351355
Entity Type Code : Individual
Provider Name (Legal Business Name) : WENDE A MOLINE APRN-BC
Provider Business Mailing Address
First Line : PO BOX 735044
Second Line :
City : CHICAGO
State : IL
Zip : 60673-5044
Country : US
Telephone Number : 800-326-2250
Fax Number :
Provider Business Practice Location Address
First Line : 2801 W KINNICKINNIC RIVER PKWY
Second Line :
City : MILWAUKEE
State : WI
Zip : 53215-3669
Country : US
Telephone Number : 414-649-1280
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2005
Last Update Date : 01/26/2025

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Directions to “ WENDE A MOLINE APRN-BC” Practice Location

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