Look up the most recent NPI and PECOS records

Nicole R Hall

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

2901 S Kinnickinnic Ave, Milwaukee, WI 53215

PECOS Enrollment

Based on the most recent information from CMS, provider Nicole R Hall does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1992105621
Provider Type
Individual
Full Name
Hall, Nicole R
Credential
NP

Gender
Female
Sole Proprietor
No
Enumeration Date
8/29/2014
Last Updated
11/23/2021

Contact Information

Practice Location

2901 S Kinnickinnic Ave, Milwaukee, WI 53215

(414) 646-3985

Unlisted Fax

Mailing Location

2901 W Kinnickinnic River Pkwy, 511, Milwaukee, WI 53215

(414) 649-3780

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363L00000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 5951 Wisconsin

Provider Identifiers

ID	Description	Issuer
ID 5951-33	Description Other	Issuer STATE Wisconsin

Nicole R Hall

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Heim, Julia A

Hasse, Bethany

Ellwein, Lindsay

Lesniewski, Jennifer A

Schoenick, Brittany M

Mayer, Molly Elizabeth

Niederstadt, Jennifer A

Stange, Katelyn K

Buchaklian, Celeste Miranda

Whitley, Mariel C