Nicole L Jaeckels, RN BSN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

190599-30 Issued in WI

Practice address

1516 Hilltop LN
Plymouth, WI 53073-2008

Phone

(920) 254-3323

NPI assigned

Oct 20, 2015

Last updated

Oct 20, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Nicole L Van Alstine Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor on Science - Nursing, Registered Nurse

State licenses

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

{
    "created_epoch": "1445299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445299200000",
    "number": "1861864662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1516 HILLTOP LN",
            "city": "PLYMOUTH",
            "state": "WI",
            "postal_code": "530732008",
            "telephone_number": "920-254-3323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1516 HILLTOP LN",
            "city": "PLYMOUTH",
            "state": "WI",
            "postal_code": "530732008",
            "telephone_number": "920-254-3323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAECKELS",
        "first_name": "NICOLE",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "RN BSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-20",
        "last_updated": "2015-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "190599-30",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "VAN ALSTINE",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Registered Nurse in Plymouth, WI
• Providers in Plymouth, WI by specialty
• Registered Nurse in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 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.