Nicole Mikshowsky

Primary specialty

Home Health Registered NurseTaxonomy code 163WH0200X

License

241816-30 Issued in WI

Practice address

W1425 State Road 33
Bangor, WI 54614-9221

Phone

(608) 498-0634

NPI assigned

Apr 27, 2021

Last updated

Apr 27, 2021By the provider in NPPES

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1619481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619481600000",
    "number": "1427630508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W1425 STATE ROAD 33",
            "city": "BANGOR",
            "state": "WI",
            "postal_code": "546149221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W1425 STATE ROAD 33",
            "city": "BANGOR",
            "state": "WI",
            "postal_code": "546149221",
            "telephone_number": "608-498-0634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKSHOWSKY",
        "first_name": "NICOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-27",
        "last_updated": "2021-04-27",
        "certification_date": "2021-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "WI",
            "license": "241816-30",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Theresa Bartomeo, CPM
• Tracy C. Dux, LCSW
• Healthsource of Bangor S C
• Alexander Manzella, D.C.
• Jack Anthony Manzella, D.C.
• Jennifer Marie Pederson, RN
• School District of Bangor

• Home Health Registered Nurse in Bangor, WI
• Providers in Bangor, WI by specialty
• Home Health Registered Nurse in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2021; 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.