Nicole Rae Andersen, RN
Individual provider Active NPI Home Health Registered Nurse · Superior, WI
NPI 1215664347 · NPPES record last updated Aug 8, 2022
Key facts
- NPI
- 1215664347
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Home Health Registered Nurse 163WH0200X
- License
- 1132553 (MN)
- Practice address
- 1104 Hammond Ave
Superior, WI 54880-1654 - Phone
- (218) 348-5409
- NPI assigned
- Aug 8, 2022
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1132553 | MN | MD | Home Health Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Registered Nurse | 163WH0200X | 1132553 | MN | Yes |
Addresses
Primary practice location
1104 Hammond Ave
Superior, WI 54880-1654
Mailing address
1104 Hammond Ave
Superior, WI 54880-1654
Phone (218) 348-5409
Other providers in Superior, WI
- Kathryn Akright
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- Clayton Lee Allison
- Amana Mobility LLC
- Catherine Mae Amorde
- Anderson Family Chiropractic SC
- Emily J Anderson
- Leslie Ann Anderson
- Michael Jay Anderson
- Susan Rae Androski
All providers in Superior, WI · Home Health Registered Nurse in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 8, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.