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KELLY FLACK APNP NPI 1720601297


NPI Information

NPI: 1720601297
Provider Name: KELLY FLACK, APNP
Classification: Nurse Practitioner - 363L00000X
Entity Type: Individual
Organization: AURORA MEDICAL GROUP INC

PECOS Registration: Yes

Address:
855 N WESTHAVEN DR
OSHKOSH, WI
ZIP 54904
Phone: (920) 033-8700
Get Directions

Kelly Flack, APNP is a nurse practitioner in Oshkosh, WI with 4 years of experience. The provider is (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. Kelly Flack, APNP NPI is 1720601297. 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:

855 N WESTHAVEN DR
OSHKOSH, WI
ZIP 54904-668
Phone: (920) 033-8700
Fax: (920) 456-5901

The NPI 1720601297 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 5/19/2020 and was last updated on 11/18/2021.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1163W00000XRegistered Nurse177650-30WISCONSINNo
2363LF0000XNurse PractitionerFamily10176-33WISCONSINNo
3363L00000XNurse Practitioner10176-33WISCONSINYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
110176-33OTHERWISCONSINWISCONSIN APNP LICENSE
2100146891MEDICAIDWISCONSIN
3177650-30OTHERWISCONSINWISCONSIN RN LICENSE

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: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.