1952830499 NPI number — DR. BRITNEY ANN WENIG DPM

Table of content: MRS. MEGAN SHOEMAKER WILLIAMS MCD/CCC-SLP (NPI 1972839926)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952830499 NPI number — DR. BRITNEY ANN WENIG DPM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WENIG
Provider First Name:
BRITNEY
Provider Middle Name:
ANN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DPM
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ROBERTS
Provider Other First Name:
BRITNEY
Provider Other Middle Name:
ANN
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1952830499
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/18/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 19070
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GREEN BAY
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
54307-9070
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
920-496-4700
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3113 SAEMANN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SHEBOYGAN
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
53081-1957
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
920-496-4700
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/08/2017

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 213ES0103X , with the licence number:  5901400395 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 213ES0103X , with the licence number: 1323-25 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 213ES0103X , with the licence number: 07001327A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 07001327A . This is a "INDIANA PROFESSIONAL LICENSING" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 100282344 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 5315224030 . This is a "CSR" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 5901400395 . This is a "MICHIGAN PROFESSIONAL LICENSE" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 07001327B . This is a "CSR - PODIATRIST" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".




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