Individual ProviderKristin R NisiewiczSocial WorkerBehavioral Health & Social Service ProvidersPractice Address5000 W National Ave, Milwaukee, WI 53295-0001(414) 384-2000PECOS EnrollmentBased on the most recent information from CMS, provider Kristin R Nisiewicz does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1275550188Provider TypeIndividualFull NameNisiewicz, Kristin RTitleMrs.CredentialAPSWGenderFemaleSole ProprietorNoEnumeration Date7/16/2006Last Updated7/8/2007Contact InformationPractice LocationPractice Address5000 W National Ave, Milwaukee, WI 53295-0001Phone(414) 384-2000Fax(414) 389-4161Mailing LocationMailing Address5641 N Bethmaur Ln, Glendale, WI 53209-4202Phone(414) 384-2000Fax(414) 389-4161Provider TaxonomiesCodeDescriptionLicenseCode104100000XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense2103-121Wisconsin