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MS. NICOLE MARIE PETRYKOWSKI FNP NPI 1548990286


NPI Information

NPI: 1548990286
Provider Name: MS. NICOLE MARIE PETRYKOWSKI, FNP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
4921 PARKVIEW PL
DIV IM MEDICAL ONCOLOGY, STE 7A, 7B, 7C
SAINT LOUIS, MO
ZIP 63110
Phone: (800) 647-2098
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MS. Nicole Marie Petrykowski, FNP is a family nurse practitioner in Saint Louis, MO with 2 years of experience. MS. Nicole Marie Petrykowski, FNP NPI is 1548990286. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: CREIGHTON UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:2022

The provider's business location address is:

4921 PARKVIEW PL
DIV IM MEDICAL ONCOLOGY, STE 7A, 7B, 7C
SAINT LOUIS, MO
ZIP 63110-032
Phone: (800) 647-2098
Fax: (314) 362-3192

The NPI 1548990286 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 6/15/2022 and was last updated on 4/25/2024.


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 PractitionerFamily2022021670MISSOURIYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1420112872MEDICAIDMISSOURI

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: 5/5/2024

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.