Jolleen Mary Nichols, DNP is a medicare enrolled "Nurse Practitioner" in Clear Lake, Wisconsin. She graduated from nursing school in 2019 and has 6 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Amery Regional Medical Center Inc and her current practice location is
357 Third Ave, Clear Lake, Wisconsin. You can reach out to her office (for appointments etc.) via phone at
(715) 268-8000.
Jolleen Mary Nichols is licensed to practice in Wisconsin (license number 9572) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1770134892.
Provider's Profile
| Full Name | Jolleen Mary Nichols |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 6 Years |
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| Location | 357 Third Ave, Clear Lake, Wisconsin |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Jolleen Mary Nichols graduated from nursing school in 2019
NPI Data:
- NPI Number: 1770134892
- Provider Enumeration Date: 09/20/2019
- Last Update Date: 11/13/2025
Medicare PECOS Information:
- PECOS PAC ID: 4082046271
- Enrollment ID: I20191108000520
Medical Identifiers
Medical identifiers for Jolleen Mary Nichols such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1770134892 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LA2200X | Nurse Practitioner - Adult Health | 9572 (Wisconsin) | Secondary |
| 363L00000X | Nurse Practitioner | 9572 (Wisconsin) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Amery Regional Medical Center Inc | 2769391960 | 100 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Jolleen Mary Nichols allows following entities to bill medicare on her behalf.
| Entity Name | Amery Regional Medical Center Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1093763518
PECOS PAC ID: 2769391960
Enrollment ID: O20040131000207 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jolleen Mary Nichols is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Jolleen Mary Nichols, DNP
8170 33rd Ave S, Ms 21110q,
Bloomington, MN 55425
Ph: () - | Jolleen Mary Nichols, DNP
357 Third Ave,
Clear Lake, WI 54005
Ph: (715) 268-8000 |
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