NPI Code Detail JSON Logo

1104354810 NPI number — NICOLE ANNE NELSON MSN, APRN, FNP-BC

NPI Number: 1104354810
Health Care Provider/Practitioner: NICOLE ANNE NELSON MSN, APRN, FNP-BC

Information about “1104354810” NPI (NICOLE ANNE NELSON MSN, APRN, FNP-BC) exists in 1104354810 in HTML format HTML  |  1104354810 in plain Text format TXT  |  1104354810 in PDF (Portable Document Format) PDF  |  1104354810 in an XML format XML  formats.

NPI Number : 1104354810 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1104354810",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "NELSON",
    "FirstName": "NICOLE",
    "MiddleName": "ANNE",
    "NamePrefix": "MS.",
    "NameSuffix": null,
    "Credential": "MSN, APRN, FNP-BC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "MISKIEWICZ-NELSON",
    "OtherFirstName": "NICOLE",
    "OtherMiddleName": "ANNE",
    "OtherNamePrefix": "MS.",
    "OtherNameSuffix": null,
    "OtherCredential": "RN",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "2717 SIDONIA AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "LAS VEGAS",
    "MailingAddressStateName": "NV",
    "MailingAddressPostalCode": "89102-4262",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "702-569-3068",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "376 E WARM SPRINGS RD STE 110",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LAS VEGAS",
    "PracticeLocationAddressStateName": "NV",
    "PracticeLocationAddressPostalCode": "89119-4241",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "702-848-4443",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "05/24/2017",
    "LastUpdateDate": "09/03/2024",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "363LF0000X",
        "TaxonomyName": "Family Nurse Practitioner",
        "LicenseNumber": "APRN002489",
        "LicenseNumberStateCode": "NV",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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