Provider Demographics
NPI:1376603589
Name:WHEELER, JAMES LESLIE (LPN)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:LESLIE
Last Name:WHEELER
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2408 180TH. STREET
Mailing Address - Street 2:
Mailing Address - City:ALLERTON
Mailing Address - State:IA
Mailing Address - Zip Code:50008
Mailing Address - Country:US
Mailing Address - Phone:641-872-1443
Mailing Address - Fax:
Practice Address - Street 1:2418 180TH ST
Practice Address - Street 2:
Practice Address - City:ALLERTON
Practice Address - State:IA
Practice Address - Zip Code:50008-8715
Practice Address - Country:US
Practice Address - Phone:641-872-1443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAP13424164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse