DEBORAH LYNN WICKENDEN RNNP NPI 1225218746

NPI Information

  • NPI: 1225218746
  • Provider Name: DEBORAH LYNN WICKENDEN, RN,NP
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 420 W 4TH ST
    MISHAWAKA, IN
    ZIP 46544
  • Phone: (574) 307-7673

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NPI Details

Deborah Lynn Wickenden, RN,NP is a family nurse practitioner in Mishawaka, IN with 19 years of experience. Deborah Lynn Wickenden, RN,NP NPI is 1225218746. 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:

420 W 4TH ST
MISHAWAKA, IN
ZIP 46544-948
Phone: (574) 307-7673
Fax: (574) 307-7692

The NPI 1225218746 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 11/13/2007 and was last updated on 3/29/2023.

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
1363LF0000XNurse PractitionerFamily71002529AINDIANAYes

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
171002529AOTHERINDIANAINDIANA NP LICENSE

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: 11/21/2025

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