Victoria Cross, APNP
Individual provider Active NPI Family Nurse Practitioner · Berlin, WI
NPI 1902807803 · NPPES record last updated Oct 3, 2017
Key facts
- NPI
- 1902807803
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 424 (WI)
- Practice address
- 191 Memorial Dr
Berlin, WI 54923-1241 - Phone
- (920) 361-2500
- Fax
- (920) 361-2973
- NPI assigned
- Aug 2, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86971-030 | WI | MD | Registered Nurse |
| 424-033 | WI | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thedacare, Incorporated | Current |
Accepting new patients | |
| Ascension Medical Group-Southeast Wisconsin Inc | Nurse Practitioner | Current |
Accepting new patients |
Locations
4480 W Spencer St
Appleton, WI 54914
Phone (920) 738-4800
2500 E Capitol Dr
Ste 2500
Appleton, WI 54911
191 Memorial Dr
#100
Berlin, WI 54923
191 Memorial Dr
Berlin, WI 54923
Phone (920) 223-5580
225 Memorial Dr
Berlin, WI 54923
Phone (920) 361-1313
13950 W Capitol Dr
Brookfield, WI 53005
Phone (414) 302-5400
1405 Mill St
New London, WI 54961
Phone (920) 531-2000
500 S Oakwood Rd
Oshkosh, WI 54904
Phone (920) 223-0501
201 N Mayfair Rd
Fl 2
Wauwatosa, WI 53226
Phone (414) 771-8228
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 86971-030 | WI | |
| Nurse Practitioner | 363L00000X | 424-033 | WI | |
| Family Nurse Practitioner | 363LF0000X | 424 | WI | Yes |
Addresses
Primary practice location
191 Memorial Dr
Berlin, WI 54923-1241
Mailing address
191 Memorial Dr
Berlin, WI 54923-1241
Phone (920) 361-2500
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 43986200 | Medicaid | WI |
Other providers in Berlin, WI
- City of Berlin
- Michelle Clauson
- Community Health Network
- Community Health Network Inc
- County of Green Lake
- Maria Graziella Cruz-Apolinario
- Mary Swieskowski Cummins
- Rebecca Davis
- Courtney Disterhaft
- Tiffani L Driessen
All providers in Berlin, 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 Oct 3, 2017. 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).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.