Michelle L Kolodzek, R.N.
Individual provider Active NPI Registered Nurse · Greendale, WI
NPI 1891955464 · NPPES record last updated Jun 16, 2008
Key facts
- NPI
- 1891955464
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 133069-030 (WI)
- Practice address
- 7210 Edgehill Rd
Greendale, WI 53129-1724 - Phone
- (414) 708-0639
- NPI assigned
- Jun 16, 2008
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 133069-030 | WI | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 133069-030 | WI | Yes |
Addresses
Primary practice location
7210 Edgehill Rd
Greendale, WI 53129-1724
Mailing address
7210 Edgehill Rd
Greendale, WI 53129-1724
Phone (414) 708-0639
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 35060000 | Medicaid | WI |
Other providers in Greendale, WI
- Leanne M Kendzierski
- Samantha Rose Khundmiri
- Amanda Nicole Klaeser
- Catherine Elizabeth Klemowits
- Matthew James Klinker
- Kelli Lauren Kramer
- Kelley Kraninger
- Gregory Sylvester Kuzniewski
- Lakeshore Family Dental Center Greendale LLC
- LCS Greendale LLC
All providers in Greendale, WI · Registered Nurse in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 16, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.