Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mary Ann Wietbrock, RNMSNACNS-BC

Individual provider Clinical Nurse Specialist · NPI 1336551175

Mary Ann Wietbrock, RNMSNACNS-BC is a Certified Clinical Nurse Specialist (Cns) in Cumberland, Indiana. Qualified in 2008, 18 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in Indiana.

Years since qualifying
18
Licensed in
IN
In the registry since
2014

Practice location Address checks out

102 Granby Dr
Cumberland, IN 46229-4203
Phone: (317) 410-9140
Fax: (317) 861-1556
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Nurse Specialist (primary) Taxonomy 364S00000X · Licence 28088637A (IN)

Record details

NPI number1336551175
Entity typeIndividual (Type 1)
GenderFemale
Credentials RNMSNACNS-BC
Sole proprietorYes
NPI enumeratedMay 28, 2014
Last updated in NPPESOctober 17, 2024
Certification dateOctober 17, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED CLINICAL NURSE SPECIALIST (CNS)
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount