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General NPI Number Information
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NPI Number | 1205811353
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Entity Type | Individual
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Provider Name | NICOLA ULLERY ARNP CNM
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Gender | Female
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Dates
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Enumeration Date | 12/13/2005
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Last Update Date | 06/29/2021
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Provider Practice Location Address
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Address Line | 11511 NE 10TH ST
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City | BELLEVUE
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State | WA
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Zip | 98004-8578
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Country | US
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Telephone | 425-502-4241
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Fax |
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Provider Business Mailing Address
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Address Line | 6002 NO WESTGATO BLVD STE 230
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City | TACOMA
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State | WA
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Zip | 98406
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Country | US
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Telephone | 253-761-2244
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Fax | 253-761-1040
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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 | 363LX0001X
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Taxonomy Name | Obstetrics & Gynecology Nurse Practitioner
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License Number | 025804 AP30004607
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN00105528
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | 025804 AP30004607
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License Number State | WA
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