Kristen Roelke, RN
Individual provider Active NPI Registered Nurse · Plain, WI
NPI 1043797913 · NPPES record last updated Jul 24, 2018
Key facts
- NPI
- 1043797913
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 152819-030 (WI)
- Practice address
- 1550 Wildwood Dr
Plain, WI 53577-9644 - Phone
- (608) 546-9834
- NPI assigned
- Jul 24, 2018
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 152819-030 | WI | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 152819-030 | WI | Yes |
Addresses
Primary practice location
1550 Wildwood Dr
Plain, WI 53577-9644
Mailing address
E4740 Rolling Ridge Rd
Spring Green, WI 53588-9262
Other providers in Plain, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 24, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.