NPIMap

Individual provider Active NPI

Nichole Lynn Hultman, AGNP

  • Adult Health Nurse Practitioner
  • River Falls, WI
National Provider Identifier
1851151138
Registry record updated Sep 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
15220-33 Issued in WI
Practice address
1617 E Division St
River Falls, WI 54022-1571
Phone
(715) 307-6600
NPI assigned
Mar 21, 2024
Last updated
Sep 24, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 15220-33 WI Primary
Adult Health Nurse Practitioner 363LA2200X 11428 MN
Primary Care Nurse Practitioner 363LP2300X 11428 MN

Addresses

Primary practice location

1617 E Division St
River Falls, WI 54022-1571

Mailing address

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (612) 262-9000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nhultman186590@excellian.direct.allina.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240610003247 WI Practitioner - Nurse Practitioner 6800338518 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians

Practice addresses (Care Compare)

1617 E Division St
River Falls, WI 54022-1571
Phone (715) 307-6600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System CurrentSince Jun 17, 2024 Accepting new patients
Allina Health System CurrentSince Jun 17, 2024 Accepting new patients
Allina Health System Past Accepting new patients

Locations

2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813

1629 E Division St
River Falls, WI 54022
Phone (715) 307-6000

1617 E Division St
River Falls, WI 54022
Phone (715) 307-6600

Interoperability endpoints

  • Direct secure messaging: nhultman186590@excellian.direct.allina.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 27

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1710979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1851151138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071321",
            "telephone_number": "612-262-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1617 E DIVISION ST",
            "city": "RIVER FALLS",
            "state": "WI",
            "postal_code": "540221571",
            "telephone_number": "715-307-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HULTMAN",
        "first_name": "NICHOLE",
        "middle_name": "LYNN",
        "credential": "AGNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-21",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "WI",
            "license": "15220-33",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MN",
            "license": "11428",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MN",
            "license": "11428",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nhultman186590@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "1617 E Division St",
            "city": "River Falls",
            "state": "WI",
            "country_code": "US",
            "postal_code": "540221571",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in River Falls, WI

Sources for this page

Verify at the official NPI Registry.