Healthcare Provider Details

I. General information

NPI: 1265979900
Provider Name (Legal Business Name): NICOLE BARTREAU FNP, PMHNP, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NICOLE SHEETS

II. Dates (important events)

Enumeration Date: 01/19/2017
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3130 N ARIZONA AVE STE 104
CHANDLER AZ
85225-7163
US

IV. Provider business mailing address

929 N. VAL VISTA DR. STE 109 #1299
GILBERT AZ
85234-3701
US

V. Phone/Fax

Practice location:
  • Phone: 480-485-0026
  • Fax:
Mailing address:
  • Phone: 480-818-9188
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP9807
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP9807
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN181769
License Number StateAZ
# 4
Primary TaxonomyN
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberL87257
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: