Individual provider Active NPI

Charlotte P Tyskiewicz, RN

  • Registered Nurse
  • Merrill, WI
National Provider Identifier
1972732535
Registry record updated Jul 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
98105-030 Issued in WI
Practice address
N2866 Hwy K
Merrill, WI 54452-9409
Phone
(715) 536-7952
NPI assigned
Jul 3, 2009
Last updated
Jul 3, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 3, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 98105-030 WI Primary
Registered Nurse 163W00000X 4704262882 MI

Addresses

Primary practice location

N2866 Hwy K
Merrill, WI 54452-9409

Mailing address

N2866 Hwy K
Merrill, WI 54452-9409
Phone (715) 536-7952

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
4704262882MIMDRegistered Nurse
98105-030WIMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1246579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246579200000",
    "number": "1972732535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N2866 HWY K",
            "city": "MERRILL",
            "state": "WI",
            "postal_code": "544529409",
            "telephone_number": "715-536-7952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N2866 HWY K",
            "city": "MERRILL",
            "state": "WI",
            "postal_code": "544529409",
            "telephone_number": "715-536-7952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYSKIEWICZ",
        "first_name": "CHARLOTTE",
        "middle_name": "P",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-03",
        "last_updated": "2009-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "98105-030",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704262882",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merrill, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2009; 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.