Nicole Jane Phillips, RN, BSN, CLC

Primary specialty

Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X

License

184153-30 Issued in WI

Practice address

1300 W Main Ave
De Pere, WI 54115-9366

Phone

(920) 336-6594

NPI assigned

May 1, 2023

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor on Science - Nursing, Registered Nurse

State licenses

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

{
    "created_epoch": "1682899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686700800000",
    "number": "1134817760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2358 JOURDAIN LN",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543012138",
            "telephone_number": "920-360-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 W MAIN AVE",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541159366",
            "telephone_number": "920-336-6594"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "835 S Van Buren St",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543013575",
            "country_code": "US",
            "telephone_number": "920-433-8538",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "NICOLE",
        "middle_name": "JANE",
        "credential": "RN, BSN, CLC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-01",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "WI",
            "license": "184153-30",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher James Peterson, DMD
• Kathryn M. Peterson, LPC
• Jeremy Daneil Petroski, LCSW
• Kathleen Phelps, MS, OTR/L
• Laura Phillips, LCSW
• Sarah A Phillips, LCSW, CSAC
• Cynthia Ann Pickworth
• Connon Lee Piencikowski, D.C.
• Christy Pitsch, BCBA
• Autumn Leigh Ann Placek, RN

• Lactation Consultant (Registered Nurse) in De Pere, WI
• Providers in De Pere, WI by specialty
• Lactation Consultant (Registered Nurse) in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 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.