Individual
NICOLE BURNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, APNP, FNP-BC
Contact information
Practice address
6127 GREEN BAY RD STE 100, KENOSHA, WI 53142-2941
(262) 652-2887
Mailing address
2527 OLE DAVIDSON RD, MOUNT PLEASANT, WI 53405-1442
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
6425-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100046073
—
WI
Enumeration date
07/06/2015
Last updated
04/16/2020
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