Amanda Nichols, APNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4571-33 Issued in WI

Practice address

3263 Eaton Rd
Green Bay, WI 54311-6830

Phone

(920) 433-6700

Fax

(920) 433-6719

NPI assigned

Oct 5, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: amanda.nichols@337248305217540.direct.elationemr.com
• Direct secure messaging: awoulf68754@direct.thedacare.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Lakeshore Radiology Associates SC

  • Diagnostic Radiology Physician
  • Manitowoc, WI
  • NPI 1346265915
  NPD (past)

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

{
    "created_epoch": "1317772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1427332790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2740 W MASON ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543034966",
            "telephone_number": "920-498-5436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3263 EATON RD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543116830",
            "telephone_number": "920-433-6700",
            "fax_number": "920-433-6719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "AMANDA",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-05",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "4571-33",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "4571-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nexora Medical Transport LLC
• Jimmy Khang Nguyen, PA-C
• Thuy Nguyen, DMD
• Vannhu Nguyen, M.D.
• Shay Nicholas, M.D.
• Katelyn Ellen Nichols, PHARMD
• Lindsey Catherine Nichols
• Morgan Nicholson, RDH
• Joel William Nickel, DC
• Nicolas Abujamra DDS Ms LTD

• Family Nurse Practitioner in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Family Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.