Healthcare Provider Details

I. General information

NPI: 1720900822
Provider Name (Legal Business Name): ST. NICHOLAS HOSPITAL-SISTERS OF THE THIRD ORDER OF ST FRANCIS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1703 N TAYLOR DR
SHEBOYGAN WI
53081-1933
US

IV. Provider business mailing address

PO BOX 19070
GREEN BAY WI
54307-9070
US

V. Phone/Fax

Practice location:
  • Phone: 920-496-4700
  • Fax:
Mailing address:
  • Phone: 920-496-4700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: JOHN WAGNER
Title or Position: MARKET COO
Credential:
Phone: 920-496-4700