KRISTIE ANN WICKMAN FNP NPI 1649618323

NPI Information

  • NPI: 1649618323
  • Provider Name: KRISTIE ANN WICKMAN, FNP
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1726 SHAWANO AVE
    GREEN BAY, WI
    ZIP 54303
  • Phone: (920) 255-5586

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NPI Details

Kristie Ann Wickman, FNP is a family nurse practitioner in Green Bay, WI with 4 years of experience. Kristie Ann Wickman, FNP NPI is 1649618323. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1726 SHAWANO AVE
GREEN BAY, WI
ZIP 54303-216
Phone: (920) 255-5586

The NPI 1649618323 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/4/2013 and was last updated on 11/14/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamily13120WISCONSINYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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