Nicole Renee Gurnoe

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

5631-125 Issued in WI

Practice address

36745 Aiken Rd
Bayfield, WI 54814-4579

Phone

(715) 779-3707

Fax

(715) 779-3711

NPI assigned

May 5, 2015

Last updated

May 5, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Nicole Renee Blanche Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Red Cliff Band of Lake Superior Chippewa Indians

  dba Red Cliff Ambulance Service

  • Land Ambulance
  • Bayfield, WI
  • NPI 1174672844
  NPD
• Red Cliff Band of Lake Superior Chippewa Indians

  dba Red Cliff Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Bayfield, WI
  • NPI 1497744015
  NPD

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

{
    "created_epoch": "1430784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430784000000",
    "number": "1063899516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36745 AIKEN RD",
            "city": "BAYFIELD",
            "state": "WI",
            "postal_code": "548144579",
            "telephone_number": "715-779-3707",
            "fax_number": "715-779-3711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36745 AIKEN RD",
            "city": "BAYFIELD",
            "state": "WI",
            "postal_code": "548144579",
            "telephone_number": "715-779-3707",
            "fax_number": "715-779-3711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GURNOE",
        "first_name": "NICOLE",
        "middle_name": "RENEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-05",
        "last_updated": "2015-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "5631-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "BLANCHE",
            "middle_name": "RENEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mark Avery Fuller, MD
• Jacob P Geisler, MSW
• Martin A Gordon
• Isabel Georgiane Gregersen, LCSW
• Melissa Grooms, MS
• Grace M Heitsch, M.D.
• Ellie Heydari, DDS
• Allyssa Kimberly Hoopman
• Patricia M. Kenote-Deperry
• Tamara L Kolesar, LPC-IT, SAC-IT

• Mental Health Counselor in Bayfield, WI
• Providers in Bayfield, WI by specialty
• Mental Health Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.