Healthcare Provider Details

I. General information

NPI: 1972117216
Provider Name (Legal Business Name): NICOLE HYMEL LPC, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/03/2020
Last Update Date: 09/05/2025
Certification Date: 09/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

213 FIRST ST S
WIGGINS MS
39577-2735
US

IV. Provider business mailing address

213 FIRST ST S
WIGGINS MS
39577-2735
US

V. Phone/Fax

Practice location:
  • Phone: 228-331-3310
  • Fax: 228-284-1608
Mailing address:
  • Phone: 228-331-3310
  • Fax: 228-284-1608

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR872587
License Number StateMS
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number3324
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: