Nicole Ivy-Kutzler, WHNP

Primary specialty

Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X

License

759653 Issued in TX

Practice address

101 Bodin Cir
Travis Afb, CA 94535-1809

Phone

(707) 816-7894

NPI assigned

Aug 19, 2010

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

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: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1282176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282176000000",
    "number": "1164738811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "891 SONNET DR",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956877263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BODIN CIR",
            "city": "TRAVIS AFB",
            "state": "CA",
            "postal_code": "945351809",
            "telephone_number": "707-816-7894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVY-KUTZLER",
        "first_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "WHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-19",
        "last_updated": "2010-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "TX",
            "license": "759653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul Hutchinson, M.D.
• George Da-Chang Hwang, DDS
• Laura Lea Ibanez, BSN, RN
• Ilda Y Isaza, D.O.
• Mary Issitt, IDMT
• Joshua Izenbart, DPT
• Tyler Jackson, LCSW
• Isaac Daniel James Jr., IDMT
• Morgan Jardon, OTR/L
• Nicholas Patrick Jelacic, MD

• Obstetrics & Gynecology Nurse Practitioner in Travis Afb, CA
• Providers in Travis Afb, CA by specialty
• Obstetrics & Gynecology Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2010; 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.