Kelly Nicole Nelson, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

7305-33 Issued in WI

Practice address

8800 Washington Ave Ste 200
Mount Pleasant, WI 53406

Phone

(262) 898-7970

Fax

(262) 635-6621

NPI assigned

May 29, 2018

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

Interoperability endpoints

• Direct secure messaging: knelson4334@direct.chw.org

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

{
    "created_epoch": "1527552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528675200000",
    "number": "1669963344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 W WISCONSIN AVE # MS 958",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264874",
            "telephone_number": "414-266-7615",
            "fax_number": "414-266-6238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8800 WASHINGTON AVE STE 200",
            "city": "MOUNT PLEASANT",
            "state": "WI",
            "postal_code": "53406",
            "telephone_number": "262-898-7970",
            "fax_number": "262-635-6621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "KELLY",
        "middle_name": "NICOLE",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-29",
        "last_updated": "2018-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "169966",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "7305-33",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1669963344",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Roxann Nauman
• Ubaid Nawaz, M.D.
• Deepak Joseph Neduvelil, D.D.S.
• Melora Lindsay Nelmark, LMT
• David Eugene Nelson, DDS
• Stephanie Nelson, LAT, ATC
• Randall S Nemerovski, MD
• Neuro Advantage Rehabilitation, LLC
• Jack Conor Neylon
• Tran Nguyen

• Family Nurse Practitioner in Mount Pleasant, WI
• Providers in Mount Pleasant, 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 11, 2018; 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.