JEANNE RAY WIEDEMANN NNP-BC NPI 1861728495

NPI Information

NPI: 1861728495
Provider Name: JEANNE RAY WIEDEMANN, NNP-BC
Classification: Nurse Practitioner - 363LN0000X
Entity Type: Individual

Specialization: Neonatal

PECOS Registration: Yes

Address:
7720 N 16TH ST
STE 425
PHOENIX, AZ
ZIP 85020
Phone: (602) 476-8962
Get Directions

Jeanne Ray Wiedemann, NNP-BC is a neonatal nurse practitioner in Phoenix, AZ. Jeanne Ray Wiedemann, NNP-BC NPI is 1861728495. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

7720 N 16TH ST
STE 425
PHOENIX, AZ
ZIP 85020-492
Phone: (602) 476-8962
Fax: (623) 643-9236

The NPI 1861728495 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/2/2009 and was last updated on 10/13/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	163W00000X	Registered Nurse		RN080027	ARIZONA	No
2	363LN0000X	Nurse Practitioner	Neonatal	AP2464	ARIZONA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	575555	MEDICAID	ARIZONA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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