Individual provider Active NPI

Nicole Nieuwsma, RN, CWON

  • Wound Care Registered Nurse
  • Minneapolis, MN
National Provider Identifier
1114619350
Registry record updated May 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Wound Care Registered NurseTaxonomy code 163WW0000X
License
40303 Issued in ND
Practice address
2240 Drew Ave S
Minneapolis, MN 55416-3646
Phone
(701) 220-9262
NPI assigned
May 25, 2023
Last updated
May 25, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Wound Care Registered Nurse 163WW0000X 40303 ND Primary
Ostomy Care Registered Nurse 163WX1500X 40303 ND

Addresses

Primary practice location

2240 Drew Ave S
Minneapolis, MN 55416-3646

Mailing address

2240 Drew Ave S
Minneapolis, MN 55416-3646
Phone (701) 220-9262

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
40303NDMDOstomy Care Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1684972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684972800000",
    "number": "1114619350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2240 DREW AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554163646",
            "telephone_number": "701-220-9262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2240 DREW AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554163646",
            "telephone_number": "701-220-9262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEUWSMA",
        "first_name": "NICOLE",
        "credential": "RN, CWON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-25",
        "last_updated": "2023-05-25",
        "certification_date": "2023-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WW0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Wound Care",
            "state": "ND",
            "license": "40303",
            "primary": true
        },
        {
            "code": "163WX1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ostomy Care",
            "state": "ND",
            "license": "40303",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2023; 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.