=====================================================
General NPI Number Information
=====================================================
NPI Number | 1154284099
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | NICOLE KAPPELL LMT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/08/2025
-----------------------------------------------------
Last Update Date | 12/08/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 313 CROOKS AVE
-----------------------------------------------------
City | KAUKAUNA
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 54130-2657
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 920-462-8129
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 917 EDEN AVE
-----------------------------------------------------
City | KAUKAUNA
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 54130-2657
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 920-462-8129
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225700000X
-----------------------------------------------------
Taxonomy Name | Massage Therapist
-----------------------------------------------------
License Number | 12963-146
-----------------------------------------------------
License Number State | WI
-----------------------------------------------------