Healthcare Provider Details

I. General information

NPI: 1902626799
Provider Name (Legal Business Name): NICOLL MISCHEL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/15/2024
Last Update Date: 10/15/2024
Certification Date: 10/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7700 E ARAPAHOE RD STE 220
CENTENNIAL CO
80112-1268
US

IV. Provider business mailing address

7700 E ARAPAHOE RD STE 220
CENTENNIAL CO
80112-1268
US

V. Phone/Fax

Practice location:
  • Phone: 800-516-0975
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: