Individual ProviderKristin NeilsenNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address1380 Tullar Rd, Neenah, WI 54956-4440(920) 727-6480(920) 996-3298PECOS EnrollmentBased on the most recent information from CMS, provider Kristin Neilsen is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1902841497Provider TypeIndividualFull NameNeilsen, KristinCredentialNPGenderFemaleSole ProprietorNoEnumeration Date6/18/2006Last Updated4/16/2014Contact InformationPractice LocationPractice Address1380 Tullar Rd, Neenah, WI 54956-4440Phone(920) 727-6480Fax(920) 727-3490Mailing LocationMailing AddressPO Box 8003, Appleton, WI 54912-8003Phone(920) 996-3298Fax(920) 738-5787Provider TaxonomiesCodeDescriptionLicenseCode363L00000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense347WisconsinProvider IdentifiersIDDescriptionIssuerID39901400DescriptionMedicaidIssuerUnlistedWisconsin