Healthcare Provider Details

I. General information

NPI: 1407794571
Provider Name (Legal Business Name): NICHOLAS FIGURACION STUDENT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2026
Last Update Date: 03/23/2026
Certification Date: 03/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 HAWKINS DR
IOWA CITY IA
52242-1009
US

IV. Provider business mailing address

626 CATHERINE DR
TIFFIN IA
52340-8034
US

V. Phone/Fax

Practice location:
  • Phone: 319-384-2196
  • Fax:
Mailing address:
  • Phone: 973-508-9250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number168475
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: