Krystine Amber Breedlove, ACNPC-AG in Fond Du Lac, WI

Krystine Amber Breedlove, ACNPC-AG is a medicare enrolled "Nurse Practitioner" in Fond Du Lac, Wisconsin. Her current practice location is 210 Wisconsin American Dr, Fond Du Lac, Wisconsin. You can reach out to her office (for appointments etc.) via phone at (920) 907-7500.

Krystine Amber Breedlove is licensed to practice in Arizona (license number 249005) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1376146910.

Contact Information

	Krystine Amber Breedlove, ACNPC-AG
	210 Wisconsin American Dr, Fond Du Lac, WI 54937-2999
	(920) 907-7500
	Not Available

Map and Direction

Provider's Profile

Full Name	Krystine Amber Breedlove
Gender	Female
Speciality	Nurse Practitioner
Location	210 Wisconsin American Dr, Fond Du Lac, Wisconsin
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1376146910
Provider Enumeration Date: 11/17/2020
Last Update Date: 02/24/2026

Medicare PECOS Information:

PECOS PAC ID: 0143697037
Enrollment ID: I20221107000753

Medical Identifiers

Medical identifiers for Krystine Amber Breedlove such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1376146910	NPI	-	NPPES
100390999	Medicaid	WI

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LA2100X	Nurse Practitioner - Acute Care	249005 (Arizona)	Secondary
363L00000X	Nurse Practitioner	249005 (Arizona)	Primary
363L00000X	Nurse Practitioner	17458-33 (Wisconsin)	Secondary
163W00000X	Registered Nurse	RN201982 (Arizona)	Secondary

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. Krystine Amber Breedlove allows following entities to bill medicare on her behalf.

Entity Name	Texas Ips Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1629368535 PECOS PAC ID: 9638356801 Enrollment ID: O20110616000075

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. Krystine Amber Breedlove 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
Krystine Amber Breedlove, ACNPC-AG Po Box 735044, Chicago, IL 60673-5044 Ph: (800) 326-2250	Krystine Amber Breedlove, ACNPC-AG 210 Wisconsin American Dr, Fond Du Lac, WI 54937-2999 Ph: (920) 907-7500

Reviews and Comments

Nurse Practitioner Nurses in Fond Du Lac, WI

Jeanette Roehl, APNP FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 210 Wisconsin American Dr, Fond Du Lac, WI 54937 Phone: 920-907-7000
Mary R Kelm, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 420 E Division St, Fond Du Lac, WI 54935 Phone: 920-926-8230
Michelle Kehrmeyer, N.P. Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 420 E Division St, Fond Du Lac, WI 54935 Phone: 209-926-4197 Fax: 920-926-4197
Jessica L Habeck, DNP, APNP, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 430 E Division St, Fond Du Lac, WI 54935 Phone: 920-926-5020
Mrs. Jennifer Nicole Stephany, APNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 420 E Division St, Fond Du Lac, WI 54935 Phone: 920-926-8200 Fax: 920-926-8907
Theresa J Baseley, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 210 Wisconsin American Dr, Fond Du Lac, WI 54937 Phone: 920-907-7000 Fax: 920-907-7012
Tammy Rae Karls, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 420 E Division St, Fond Du Lac, WI 54935 Phone: 920-926-8495

Krystine Amber Breedlove, ACNPC-AG - Medicare Nurse Practitioner in Fond Du Lac, WI