Healthcare Provider Details

I. General information

NPI: 1093102402
Provider Name (Legal Business Name): NICOLE E HEMBEL NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2015
Last Update Date: 04/08/2025
Certification Date: 04/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

342 N WATER ST STE 600
MILWAUKEE WI
53202-5715
US

IV. Provider business mailing address

342 N WATER ST STE 600
MILWAUKEE WI
53202-5715
US

V. Phone/Fax

Practice location:
  • Phone: 651-342-1039
  • Fax: 651-342-1428
Mailing address:
  • Phone: 651-342-1039
  • Fax: 651-342-1428

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number6323
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number6323
License Number StateWI
# 3
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number6323
License Number StateWI
# 4
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number6323
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: