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General NPI Number Information
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NPI Number | 1205798717
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Entity Type | Individual
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Provider Name | NICOLE MARIE LIKE AGNP-C
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Gender | Female
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Dates
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Enumeration Date | 12/02/2025
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 1350 DEMING WAY STE 400
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City | MIDDLETON
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State | WI
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Zip | 53562-4662
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Country | US
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Telephone | 608-820-1646
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Fax |
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Provider Business Mailing Address
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Address Line | 2342 HOARD ST # 1
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City | MADISON
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State | WI
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Zip | 53704-4953
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Family Medicine) Physician
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License Number | 17734-33
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License Number State | WI
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