Shannon Elizabeth Wiedeman in Enterprise - Psychiatric/mental Health
Shannon Elizabeth Wiedeman - NPI 1255596607
Shannon Elizabeth Wiedeman is a Psychiatric/mental Health in Enterprise, Oregon. Shannon Elizabeth Wiedeman practices all healthcare services and medical treatments related to Psychiatric/mental Health. The NPI Number for Shannon Elizabeth Wiedeman is 1255596607. The last update date is 2016-04-05.
Shannon Elizabeth Wiedeman's current location address is 207 Sw 1st St, Enterprise, Oregon. You can contact this provider via phone number 5414264524 and fax number 5414263035. The mailing address for Shannon Elizabeth Wiedeman is 207 Sw 1st St, Enterprise, Oregon. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Shannon Elizabeth Wiedeman |
|---|---|
| Address | 207 Sw 1st St, Enterprise, Oregon |
| Phone Number | 5414264524 |
| Fax Number | 5414263035 |
| Sole Proprietor | N |
| Credentials | NP AND |
NPI Number Detail
| NPI Number | 1255596607 |
|---|---|
| Provider Enumeration Date | 2008-07-25 |
| Last Updated Date | 2016-04-05 |
Provider Mailing Address Detail
| Address | 207 Sw 1st St |
|---|---|
| City | Enterprise |
| State | Oregon (OR) |
| Post Code | 978281203 |
| Phone Number | 5414264524 |
| Fax Number | 5414263035 |
Provider's Primary Taxonomy Detail
| Speciality | Psychiatric/mental Health |
|---|---|
| Taxonomy | 163Wp0808X |
| Licence No | 201043506RN |
|
Definition: A registered nurse who cares for patients with mental health disorders and conditions. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 500641038 | OR | -- | |
| O10244476AA | OR | REGENCE BLUE CROSS BLUE SHIELD | |
| 383864 | OR | MEDICARE RHC |
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What is the unique 10-digit identification code issued to Shannon Elizabeth Wiedeman by the Centers for Medicare & Medicaid Services?
The Shannon Elizabeth Wiedeman has been assigned the NPI (National Provider Identifier) 1255596607 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you share the physical location details of Shannon Elizabeth Wiedeman?
The Shannon Elizabeth Wiedeman is situated at 207 Sw 1St St, in the city of Enterprise, state of OR, with the zip code 978281203.
What is the Shannon Elizabeth Wiedeman's area of specialization and corresponding taxonomy classification?
The Shannon Elizabeth Wiedeman's specialty field is Psychiatric/mental Health, and it falls under the taxonomy code 163Wp0808X, which categorizes healthcare providers based on their specialties.
On what date did the Centers for Medicare & Medicaid Services issue the 1255596607 to Shannon Elizabeth Wiedeman?
The Shannon Elizabeth Wiedeman received its 1255596607 assignment from the Centers for Medicare & Medicaid Services on 2008-07-25.
When was the information pertaining to Shannon Elizabeth Wiedeman most recently updated or revised?
The details related to Shannon Elizabeth Wiedeman, including its address, specialty, and other relevant information, were last updated or revised on 2016-04-05.