KELLY KONESKO (NPI# 1588655351) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588655351 |
| Entity Type | Individual |
| Full Name | KELLY KONESKO |
| Credential | NP |
| Practice Address |
1151 Warwick Way Racine WI 53406-5661 |
| Mailing Address |
3003 W Good Hope Rd Milwaukee WI 53209-2042 |
| Practice Telephone | 2628867360 |
| Mailing Telephone | 4143523100 |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2012-01-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 1512 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 43913500 | 05 | |
| WI | RR MEDICARE | P00989255 | 01 |
| Street Address |
1151 WARWICK WAY |
| City | RACINE |
| State | WI |
| Zip Code | 53406-5661 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053302729 | Michael Mullane | Internal Medicine | 1151 Warwick Way, Racine, WI 53406-5661 | 2005-11-02 |
| 1386838340 | Phenu V Zachariah | Internal Medicine | 1151 Warwick Way, Racine, WI 53406-5661 | 2007-09-04 |
| 1518057512 | Sana Jeffreys | Internal Medicine | 1151 Warwick Way, Racine, WI 53406-5661 | 2006-10-13 |
| 1265453070 | Michael Alan Thompson | Internal Medicine | 1151 Warwick Way, Aurora Health Care, Racine, WI 53406 | 2006-07-21 |
| 1417922949 | Antony Ruggeri | Internal Medicine | 1151 Warwick Way, Racine, WI 53406-5661 | 2006-02-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578164349 | Lynn Huynh | Pharmacist | 5695 Washington Ave, Racine, WI 53406 | 2020-11-06 |
| 1659920049 | Carol Jean Cornejo | Technician | 6528 Heritage Avenue, Mt Pleasant, WI 53406 | 2019-09-09 |
| 1265913958 | Mary Goldbeck | Social Worker | 1775 Newman Rd, Mt Pleasant, WI 53406 | 2018-08-22 |
| 1669963344 | Kelly Nicole Nelson | Registered Nurse | 8800 Washington Ave Ste 200, Mount Pleasant, WI 53406 | 2018-05-29 |
| 1891212163 | Ilona Agata Pryomski | Nurse Practitioner | 9201 Washington Ave, Racine, WI 53406 | 2017-08-27 |
| 1386185106 | Margaret M. Abaogye Dds | Dentist | 4340 Newman Rd., Racine, WI 53406 | 2017-03-13 |
| 1508309212 | Rebecca Koeppen | Dietitian, Registered | 8400 Washington Ave., Racine, WI 53406 | 2016-11-29 |
| 1386194371 | Forefront Dermatology, S.c. | Dermatology | 7200 Washington Ave, Suite 100, Mount Pleasant, WI 53406 | 2016-10-13 |
| 1356891402 | Forefront Dermatology, S.c. | Dermatology | 1515 S Green Bay Rd, Racine, WI 53406 | 2016-10-12 |
| 1861841470 | Leah Marie Johnson | Dentist | 1101 South Airline Road, Racine, WI 53406 | 2016-06-06 |
| Find all providers in zip 53406 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (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. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215564554 | Christina Louise Lovely | Nurse Practitioner | 3813 Haven Ave, Racine, WI 53405-2325 | 2020-03-26 |
| 1609388693 | Renee Morin | Nurse Practitioner | 2333 Northwestern Ave, Racine, WI 53404-2520 | 2017-10-30 |
| 1891212163 | Ilona Agata Pryomski | Nurse Practitioner | 9201 Washington Ave, Racine, WI 53406 | 2017-08-27 |
| 1528088044 | Cheryl A. Magner | Nurse Practitioner | 4700 21st St, Racine, WI 53406-5031 | 2006-07-20 |
| 1578964151 | Lisa Volz | Nurse Practitioner | 3803 Spring Street, Racine, WI 53405-2452 | 2014-09-15 |
| 1639439433 | Daniel D Medlock | Nurse Practitioner | 1320 Wisconsin Ave, Racine, WI 53403-1978 | 2012-05-25 |
| 1407177991 | Rosamma T John | Nurse Practitioner | 3807 Spring St, Racine, WI 53405-1667 | 2010-06-18 |
| 1598906596 | Alyssa Skalitzky | Nurse Practitioner | 1717 Taylor Ave, Racine, WI 53403-2405 | 2009-03-20 |
| 1356534143 | Lori L Henderson | Nurse Practitioner | 3807 Spring St, 3rd Floor-east Wing, Racine, WI 53405-1667 | 2007-08-24 |
| 1265655732 | Jennifer A Niederstadt | Nurse Practitioner | 3803 Spring St, Suite 410, Racine, WI 53405-1660 | 2007-04-11 |
| Find all providers in RACINE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.