Individual
MRS. NICOLE ANN KAKUK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
2300 WESTERN AVE, MANITOWOC, WI 54220-3712
(920) 320-2011
Mailing address
2300 WESTERN AVE, MANITOWOC, WI 54220-3712
(920) 320-2011
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
232814 - 30
WI
164X00000X
Licensed Vocational Nurse
319942
WI
363L00000X
Nurse Practitioner
Primary
12223-33
WI
Other
Enumeration date
12/22/2016
Last updated
06/07/2024
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