Healthcare Provider Details

I. General information

NPI: 1285112276
Provider Name (Legal Business Name): NICHOLE CHRISTINE ALBERS PNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2018
Last Update Date: 05/28/2025
Certification Date: 05/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CHILDRENS PL DIV SURG CT PEDS, STE 2A
SAINT LOUIS MO
63110-1002
US

IV. Provider business mailing address

PO BOX 7412011
CHICAGO IL
60674-2011
US

V. Phone/Fax

Practice location:
  • Phone: 314-454-6165
  • Fax: 314-454-2381
Mailing address:
  • Phone: 314-454-6165
  • Fax: 314-454-2381

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0222X
TaxonomyCritical Care Pediatric Nurse Practitioner
License Number2018028144
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: