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NPI 1366173205ActiveIndividual· Driver· Eau Claire, WI

Driver in Eau Claire, Wisconsin, licensed in WI, with an NPI issued in June 2022.

Overview

NPI1366173205
StatusActive
Entity typeIndividual
Sole proprietorNo
NPI issuedJun 21, 2022
Last updated in NPPESJun 21, 2022
Certified by providerJun 21, 2022

Specialties and licenses

TaxonomyCodeLicenseState
Driver Primary172A00000XX5208008545609WI

About license numbers in NPPES

Exclusion screening

ListResultDetails
HHS-OIG LEIE · Oct 9, 2026No matchChecked by NPI and by name + state
North Carolina Medicaid · Nov 10, 2026No match—
New York OMIG · Nov 10, 2026No match—
Ohio Medicaid · Nov 10, 2026No match—
Pennsylvania Medicheck · Nov 10, 2026No match—
Washington HCA · Nov 10, 2026No match—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)Not in the public enrollment file of Oct 1, 2026

Medicare sources and data years

Other Driver providers in Eau Claire

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