Nicole Kulwicki, NP-C
Individual provider Active NPI Family Nurse Practitioner · Phillips, WI
NPI 1730583113 · NPPES record last updated Aug 6, 2021
Key facts
- NPI
- 1730583113
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 6063 (WI)
- Practice address
- 1300 N Airport Rd
Phillips, WI 54555-1527 - Phone
- (920) 496-4700
- NPI assigned
- Oct 14, 2014
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
- Opted out of Medicare
- Yes, effective Jun 17, 2024 through Jun 17, 2028
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6063 | WI | MD | Physical Therapist |
| 144922 | WI | MD | Family Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 144922 | WI | |
| Family Nurse Practitioner | 363LF0000X | 6063 | WI | Yes |
Addresses
Primary practice location
1300 N Airport Rd
Phillips, WI 54555-1527
Mailing address
PO Box 19070
Green Bay, WI 54307-9070
Phone (920) 496-4700
Other practice location 1
6901 W Edgerton Ave
Greenfield, WI 53220-4420
Phone (414) 427-8400
Other providers in Phillips, WI
- Haven House Community Support Center of Price County
- Hearing Advantage LLC
- Carol Jane Heinlein
- Melody Jean Jorgensen
- Deborah A Kozak
- Jennifer L Kunkel
- Lakeview Pharmacy Inc
- Rhonda Lewan
- Ashley Malchow
- Sandra Joy Maley
All providers in Phillips, WI · Family Nurse Practitioner in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 6, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.