Active NPI
Andrew Allen Malkowski, APNP
- Psychiatric/Mental Health Nurse Practitioner
- Manitowoc, WI
National Provider Identifier
1174200786
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 14012-33
- Practice address
- 926 S 8TH St
Manitowoc, WI 54220-4535 - Phone
- (920) 683-4230
- Fax
- (920) 683-4902
- NPI assigned
- Jul 5, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 14012-33 | WI | Primary |
Addresses
Primary practice location
926 S 8TH St
Manitowoc, WI 54220-4535
Mailing address
1505 North Drive
Winnebago, WI 54901
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14012-33 | WI | MD | Psychiatric/Mental Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1688515200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712016000000",
"number": "1174200786",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1505 NORTH DRIVE",
"city": "WINNEBAGO",
"state": "WI",
"postal_code": "54901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "926 S 8TH ST",
"city": "MANITOWOC",
"state": "WI",
"postal_code": "542204535",
"telephone_number": "920-683-4230",
"fax_number": "920-683-4902"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALKOWSKI",
"first_name": "ANDREW",
"middle_name": "ALLEN",
"credential": "APNP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-07-05",
"last_updated": "2024-04-02",
"certification_date": "2024-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "WI",
"license": "14012-33",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Manitowoc, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.