IndividualActive
Shannon Wiedeman, NP AND RN
NPI 1255596607 · Psychiatric/Mental Health Registered Nurse · Enterprise, OR
Provider details
- NPI number
- 1255596607
- Entity type
- Individual
- Primary specialty
- Psychiatric/Mental Health Registered NurseNursing Service Providers
- Credential
- NP AND RN
- Sex
- Female
- Sole proprietor
- No
- License
- 201050225NP (OR)
Specialties & taxonomies
Nursing Service Providers
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
Detailed profile(87/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
17 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
207 Sw 1st St
Enterprise, OR 97828-1203
Phone: (541) 426-0801
Fax: (541) 426-0802
Street-level locationGet directions
Mailing address
207 Sw 1st St
Enterprise, OR 97828-1203
Registry dates
- Enumerated
- 2008-07-25
- Last updated
- 2016-04-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.