Kay Ellen Marsicek, BSN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

97145-030 Issued in WI

Practice address

10 Tri Park Way
Appleton, WI 54914-1658

Phone

(920) 831-0070

Fax

(920) 831-7939

NPI assigned

Aug 19, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Miss Kay Ellen Bubolz Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor on Science - Nursing

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Milwaukee Vamc

  • Department of Veterans Affairs (VA) Pharmacy
  • Appleton, WI
  • NPI 1669643912
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003920679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2132 W PRAIRIE CREEK DR",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549565630",
            "telephone_number": "920-831-0070",
            "fax_number": "920-831-7939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 TRI PARK WAY",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549141658",
            "telephone_number": "920-831-0070",
            "fax_number": "920-831-7939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSICEK",
        "first_name": "KAY",
        "middle_name": "ELLEN",
        "name_prefix": "Mrs.",
        "credential": "BSN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "97145-030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAY",
            "last_name": "BUBOLZ",
            "middle_name": "ELLEN",
            "prefix": "MISS",
            "credential": "BSN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Louise E Marquardt, O.D.
• Anthony J Marquis, M.D.
• Stephen J Marquis, MD
• Rebecca Lynne Marrazzo, LPC, SACIT
• Jennifer M Marshall, PAC
• Anna Kristin Martel-Arquette, P.T.
• Brent A Martin, APNP
• Craig Joseph Martin, DC
• Don Jordan Martin, MD
• Heather Marie Martin, SAC-IT

• Registered Nurse in Appleton, WI
• Providers in Appleton, WI by specialty
• Registered Nurse in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.