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

Nicole Kristine Wannamaker

Individual provider Family Nurse Practitioner · NPI 1205453826

Nicole Kristine Wannamaker is a Nurse Practitioner in Cooperstown, New York. Qualified in 2020, 6 years ago. Practices with Mary Imogene Bassett Hospital, a 779-clinician group, accepts Medicare assignment and offers telehealth. Licensed in New York.

Years since qualifying
6
Licensed in
NY
In the registry since
2020

Practice location Address checks out

1 Atwell Rd
Cooperstown, NY 13326-1301
Phone: (607) 547-3120
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 346059 (NY)

Record details

NPI number1205453826
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJune 30, 2020
Last updated in NPPESAugust 14, 2020
Certification dateAugust 14, 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 Mary Imogene Bassett Hospital — 779 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Cooperstown