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NPI Code Detail

MEDICARE: NICHOLE NELSON

MEDICARE: NICHOLE NELSON
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
1374U00000XHome Health Aide

General Provider Information

NPI Number : 1083033252
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICHOLE NELSON
Provider Business Mailing Address
First Line : 3435 W CRAIG RD STE C
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89032-5116
Country : US
Telephone Number : 702-929-3297
Fax Number :
Provider Business Practice Location Address
First Line : 1517 SANTA ROSALIA DR
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89031-1010
Country : US
Telephone Number : 702-327-4217
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/15/2014
Last Update Date : 11/01/2021

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Directions to “ NICHOLE NELSON ” Practice Location

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