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

Nicole Lynn Wickoren, CRNA

Individual provider Certified Registered Nurse Anesthetist · NPI 1104448943

Nicole Lynn Wickoren, CRNA is a Certified Registered Nurse Anesthetist (CRNA) in Overland Park, Kansas. Qualified in 2020, 6 years ago. Practices with Northstar Anesthesia of Missouri LLC, a 83-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Kansas and Missouri.

Years since qualifying
6
Licensed in
KS, MO
In the registry since
2020
Specialties on file
3
What do these letters mean?
CRNA — Certified Registered Nurse Anesthetist
An advanced practice nurse who administers anaesthesia.

See every abbreviation used in this directory →

Practice location Address checks out

7820 W 165th St
Overland Park, KS 66223-2925
Phone: (913) 373-2000
Fax: (913) 428-2951
Show map & directions

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

Additional practice locations (1)

  • 2316 E Meyer Blvd, Kansas City, MO 64132-1136 — (913) 428-2900

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence 43-557796 (KS)
Certified Registered Nurse Anesthetist Taxonomy 367500000X · Licence 2020012946 (MO)
Registered Nurse Taxonomy 163W00000X · Licence 2005038282 (MO)

Record details

NPI number1104448943
Entity typeIndividual (Type 1)
GenderFemale
Credentials CRNA
Sole proprietorNo
NPI enumeratedMay 14, 2020
Last updated in NPPESApril 21, 2026
Certification dateApril 21, 2026

Medicare enrollment

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

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Northstar Anesthesia Of Missouri Llc — 83 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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