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NPI Code Detail

MEDICARE: JOSEPHINE M MCINTOSH APRN, CNP

MEDICARE: JOSEPHINE M MCINTOSH APRN, CNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse PractitionerR19389ND
2363LF0000XFamily Nurse Practitioner4055WI
3363LF0000XFamily Nurse Practitioner2536MN
4363LF0000XFamily Nurse PractitionerA-122356IA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3P1200504OTHERMNRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
415689OTHERIAWELLMARK BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1881797462
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSEPHINE M MCINTOSH APRN, CNP
Provider Business Mailing Address
First Line : N8931 COUNTY ROAD DK
Second Line :
City : DYCKESVILLE
State : WI
Zip : 54217-9685
Country : US
Telephone Number : 701-610-6169
Fax Number :
Provider Business Practice Location Address
First Line : 2430 E MASON ST
Second Line :
City : GREEN BAY
State : WI
Zip : 54302-3759
Country : US
Telephone Number : 920-445-7377
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/07/2006
Last Update Date : 03/28/2025

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