JOLLEEN MARY NICHOLS


Address: 357 Third Ave, Clear Lake, WI 54005
Phone: 7152688000

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).

Provider Overview

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

Taxonomy

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

Provider Secondary Practice Location

Address Telephone Number Fax Number
265 Griffin St E, Amery, WI 540011439 7152688000

Office Location

Street Address 357 THIRD AVE
City CLEAR LAKE
State WI
Zip Code 54005

Providers in the same location

NPI Name Taxonomy Address Enumeration
1366878449 Amery Regional Medical Center, Inc Clinic/Center 357 Third Ave, Clear Lake, WI 54005-0177 2013-09-19

Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 363LA2200X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Adult Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and state

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
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Competitor

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City CLEAR LAKE
Zip Code 54005

Improve Information

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Dataset Information

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.

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