Jennifer Wyckoff

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

165136-030 Issued in WI

Practice address

708 Hawthorne Ave Uppr
South Milwaukee, WI 53172-1734

Phone

(414) 458-3179

NPI assigned

Nov 1, 2011

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

Practice roles

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.

• PDN

  • Skilled Nursing Facility
  • South Milwaukee, WI
  • NPI 1588055107
  NPD (past) Authorized official

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

{
    "created_epoch": "1320105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424649600000",
    "number": "1578849725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "708 HAWTHORNE AVE UPPR",
            "city": "SOUTH MILWAUKEE",
            "state": "WI",
            "postal_code": "531721734",
            "telephone_number": "414-458-3179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 HAWTHORNE AVE UPPR",
            "city": "SOUTH MILWAUKEE",
            "state": "WI",
            "postal_code": "531721734",
            "telephone_number": "414-458-3179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYCKOFF",
        "first_name": "JENNIFER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-01",
        "last_updated": "2015-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "165136-030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wheaton Franciscan Medical Group
• Andrew James Whelan
• Makayla R White
• Luanne M Wielichowski, APRN BC
• Lynn Winter
• Liane Yockey
• Amy Jo Zahn, N.P.
• Jiemei Zhang
• Heather Ziegert

• Registered Nurse in South Milwaukee, WI
• Providers in South Milwaukee, WI by specialty
• Registered Nurse in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2015; 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.