Individual ProviderKristin VanwyngaardenSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersPractice Address5606 S 147th St, Omaha, NE 68137-2648(402) 715-8200PECOS EnrollmentBased on the most recent information from CMS, provider Kristin Vanwyngaarden does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1437521309Provider TypeIndividualFull NameVanwyngaarden, KristinTitleMissCredentialCF, SLPGenderFemaleSole ProprietorNoEnumeration Date10/30/2015Last Updated10/30/2015Contact InformationPractice LocationPractice Address5606 S 147th St, Omaha, NE 68137-2648Phone(402) 715-8200FaxUnlisted FaxMailing LocationMailing Address5606 S 147th St, Omaha, NE 68137-2648PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode235Z00000XPrimaryDescriptionSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersLicenseUnlisted IssuerProvider IdentifiersIDDescriptionIssuerID2015009512DescriptionOtherIssuerNDE STAFF ID: 2015009512Nebraska