Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Keisha Vickman

Individual provider Nurse Practitioner · NPI 1114526530

Keisha Vickman is a Nurse Practitioner in Green Bay, Wisconsin. Qualified in 2020, 6 years ago. Practices with St Vincent Hospital-Hospital Sisters-Third Order of St Francis, a 594-clinician group and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
6
Licensed in
WI
In the registry since
2020
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Practice location Address checks out

835 S Van Buren St
Green Bay, WI 54301-3526
Phone: (920) 433-0111
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 10477 (WI)

Record details

NPI number1114526530
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedOctober 19, 2020
Last updated in NPPESOctober 19, 2020
Certification dateSeptember 29, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice St Vincent Hospital-Hospital Sisters-Third Order Of St Francis — 594 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Green Bay