MEDICARE: NICOLE MARIE STEINMETZ NELSON MA

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
1	101YP2500X	Professional Counselor	7025-226	WI

General Provider Information

NPI Number	:	1376380816
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE MARIE STEINMETZ NELSON MA

Provider Business Mailing Address
First Line	:	1740 N 52ND ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53208-1748
Country	:	US
Telephone Number	:	414-704-0891
Fax Number	:

Provider Business Practice Location Address
First Line	:	801 N 27TH ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53208-3506
Country	:	US
Telephone Number	:	414-704-0891
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/11/2024
Last Update Date	:	07/11/2024

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