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General NPI Number Information
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NPI Number | 1437503828
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Entity Type | Individual
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Provider Name | NICOLE MARIE ACKLIE
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Gender | Female
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Dates
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Enumeration Date | 04/21/2016
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Last Update Date | 02/13/2018
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Provider Practice Location Address
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Address Line | 400 E NORFOLK AVE SUITE C
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City | NORFOLK
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State | NE
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Zip | 68701-5400
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Country | US
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Telephone | 402-371-4089
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Fax | 503-659-5968
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Provider Business Mailing Address
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Address Line | 8800 SE SUNNYSIDE RD STE 300N
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City | CLACKAMAS
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State | OR
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Zip | 97015-5703
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Country | US
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Telephone | 281-286-2999
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Fax | 512-607-4893
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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 | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number |
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | 817
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License Number State | NE
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