Michelle Marie Niemi, RN
Individual provider Active NPI Registered Nurse · Elkhart Lake, WI
NPI 1578102489 · NPPES record last updated Dec 26, 2019
Key facts
- NPI
- 1578102489
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 110622-30 (WI)
- Practice address
- W5609 County Road a N
Elkhart Lake, WI 53020-2031 - Phone
- (920) 627-4027
- NPI assigned
- Dec 26, 2019
- 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 |
|---|---|---|---|
| 110622-30 | WI | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 110622-30 | WI | Yes |
Addresses
Primary practice location
W5609 County Road a N
Elkhart Lake, WI 53020-2031
Mailing address
W5609 County Road a N
Elkhart Lake, WI 53020-2031
Phone (920) 627-4027
Other names
- Michelle Marie Niemi
Other providers in Elkhart Lake, WI
All providers in Elkhart Lake, WI · 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 Dec 26, 2019. 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.