JOLLEEN MARY NICHOLS (NPI# 1770134892) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1770134892 |
Entity Type | Individual |
Full Name | JOLLEEN MARY NICHOLS |
Credential | DNP |
Practice Address |
357 Third Ave Clear Lake WI 54005 |
Mailing Address |
633 210th Ave Somerset WI 54025-6940 |
Practice Telephone | 7152688000 |
Mailing Telephone | 6512263906 |
Enumeration Date | 2019-09-20 |
Last Update Date | 2019-10-03 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
9572 | WI | Physician Assistants & Advanced Practice Nursing Providers |
Address | Telephone Number | Fax Number |
---|---|---|
265 Griffin St E, Amery, WI 540011439 | 7152688000 |
Street Address |
357 THIRD AVE |
City | CLEAR LAKE |
State | WI |
Zip Code | 54005 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1366878449 | Amery Regional Medical Center, Inc | Clinic/Center | 357 Third Ave, Clear Lake, WI 54005-0177 | 2013-09-19 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1043866460 | Northern Roots Family Spinal Care, LLC | Chiropractor | 470 3rd Ave, Clear Lake, WI 54005 | 2019-08-12 |
1689855355 | Deborah Sue Cuper | Physical Therapist | 417 3rd Ave., Clear Lake, WI 54005 | 2007-11-21 |
1952595480 | Kivlin Eye Clinic, Sc | Optometrist | 370 3rd Ave, Clear Lake, WI 54005 | 2007-08-28 |
1083722920 | Bradley Alvin Paulson | Chiropractor | 336 3rd Ave, Clear Lake, WI 54005 | 2006-08-29 |
1225042013 | Emily J Monson | Physical Therapist | 417 3rd Ave, Clear Lake, WI 54005 | 2006-07-28 |
1265721781 | Krista Anderson | Physical Therapy Assistant | 417 3rd Ave, Clear Lake, WI 54005 | 2011-04-05 |
1083845754 | Clear Lake Physical Therapy and Rehab Specialists LLC | Occupational Therapist | 417 3rd Ave, Clear Lake, WI 54005 | 2009-07-29 |
1063689487 | Erin Timm | Physical Therapist | 417 3rd Ave, Clear Lake, WI 54005 | 2008-05-14 |
1245563196 | Lisa Karen Dodge | Point of Service | 571 75th St, Clear Lake, WI 54005-3819 | 2009-09-10 |
1831394741 | Stephanie L Fall | Specialist/Technologist | 751 4th St, Clear Lake, WI 54005-8505 | 2007-06-19 |
Find all providers in zip 54005 |
Taxonomy Code | 363LA2200X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Adult Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1952870289 | Sujata Karki | Nurse Practitioner | 402 N Eau Claire Ave Apt 309, Madison, WI 53705-2820 | 2018-11-15 |
1861926750 | Lisa Somers | Nurse Practitioner | W126n7338 Flint Dr, Menomonee Falls, WI 53051-4532 | 2017-04-17 |
1750828299 | Nanette Marie Kloth | Nurse Practitioner | 18110 W Bluemond Rd, Brookfield, WI 53045 | 2017-01-23 |
1902341852 | Rebecca Weld Hall | Nurse Practitioner | 3245 Milwaukee St, Madison, WI 53714-1829 | 2017-01-02 |
1629525613 | Katherine Simons Melde | Nurse Practitioner | 2222 S Park St Ste 210, Madison, WI 53713 | 2016-09-07 |
1134574643 | Victoria White | Nurse Practitioner | 2500 N Mayfair Rd Ste 260, Wauwatosa, WI 53226-1443 | 2016-05-03 |
1326414442 | Diane Marie Kelley | Nurse Practitioner | 300 Femrite Drive, Monona, WI 53716 | 2015-08-12 |
1841673829 | M Christine Meulemans | Nurse Practitioner | 3391 Wilderness Trl, Suamico, WI 54313-8746 | 2015-07-08 |
1548659725 | Patricia Ann Kender | Nurse Practitioner | 17495 W. Capitol Dr., Brookfield, WI 53045 | 2015-01-12 |
1588062947 | Laura Swett | Nurse Practitioner | 733 Woodside Dr, Seymour, WI 54165-1661 | 2014-12-16 |
Find all providers with the same taxonomy |
City | CLEAR LAKE |
Zip Code | 54005 |
Please comment or provide details below to improve the information on JOLLEEN MARY NICHOLS.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.