Individual provider Active NPI

Kristin L Klimisch, PNP

  • Pediatric Registered Nurse
  • Pleasant Prairie, WI
National Provider Identifier
1770620155
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Registered NurseTaxonomy code 163WP0200X
License
R153555 Issued in MD
Practice address
8491 E Ridge Dr
Pleasant Prairie, WI 53158-2039
Phone
(262) 764-4559
NPI assigned
Feb 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Registered Nurse 163WP0200X R153555 MD Primary

Addresses

Primary practice location

8491 E Ridge Dr
Pleasant Prairie, WI 53158-2039

Mailing address

8491 E Ridge Dr
Pleasant Prairie, WI 53158-2039
Phone (262) 764-4559

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
R153555MDMDPediatric Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1770620155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8491 E RIDGE DR",
            "city": "PLEASANT PRAIRIE",
            "state": "WI",
            "postal_code": "531582039",
            "telephone_number": "262-764-4559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8491 E RIDGE DR",
            "city": "PLEASANT PRAIRIE",
            "state": "WI",
            "postal_code": "531582039",
            "telephone_number": "262-764-4559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLIMISCH",
        "first_name": "KRISTIN",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "MD",
            "license": "R153555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasant Prairie, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.