Individual provider Active NPI

Connie Mae Kulwicki, RN, CDE

  • Diabetes Educator Registered Nurse
  • Kearney, NE
National Provider Identifier
1992322853
Registry record updated Jun 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diabetes Educator Registered NurseTaxonomy code 163WD0400X
License
38889 Issued in NE
Practice address
3219 Central Ave Ste 200
Kearney, NE 68847-2958
Phone
(308) 865-2370
Fax
(308) 865-2167
NPI assigned
Jun 26, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diabetes Educator Registered Nurse 163WD0400X 38889 NE Primary

Addresses

Primary practice location

3219 Central Ave Ste 200
Kearney, NE 68847-2958

Mailing address

3219 Central Ave Ste 200
Kearney, NE 68847-2958
Phone (308) 865-2370

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
38889NEMDDiabetes Educator Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Alegent Creighton Clinic Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1593129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593129600000",
    "number": "1992322853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3219 CENTRAL AVE STE 200",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688472958",
            "telephone_number": "308-865-2370",
            "fax_number": "308-865-2167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3219 CENTRAL AVE STE 200",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688472958",
            "telephone_number": "308-865-2370",
            "fax_number": "308-865-2167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KULWICKI",
        "first_name": "CONNIE",
        "middle_name": "MAE",
        "credential": "RN, CDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-26",
        "last_updated": "2020-06-26",
        "certification_date": "2020-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "NE",
            "license": "38889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kearney, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2020; 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.