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NPI Code Detail

MEDICARE: MARISSA WENGERT

MEDICARE: MARISSA WENGERT
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1659230001
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARISSA WENGERT
Provider Business Mailing Address
First Line : 5118 CROOKSHANK RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45238-3304
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5118 CROOKSHANK RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45238-3304
Country : US
Telephone Number : 513-441-1374
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/21/2026
Last Update Date : 01/21/2026

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Directions to “ MARISSA WENGERT ” Practice Location

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