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General NPI Number Information
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NPI Number | 1487425443
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Entity Type | Individual
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Provider Name | NICOLE MARIE VAN DE VOORDE RN
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Gender | Female
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Dates
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Enumeration Date | 01/09/2024
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Last Update Date | 01/09/2024
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Provider Practice Location Address
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Address Line | 2211 NE 139TH ST
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City | VANCOUVER
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State | WA
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Zip | 98686-2742
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Country | US
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Telephone | 360-487-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 10414 NE 95TH AVE
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City | VANCOUVER
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State | WA
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Zip | 98662-3414
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Country | US
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Telephone | 503-545-8363
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 201601307RN
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 163WE0003X
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Taxonomy Name | Emergency Registered Nurse
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License Number | 201601307RN
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 163WM0102X
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Taxonomy Name | Maternal Newborn Registered Nurse
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License Number | 201601307RN
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License Number State | OR
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Taxonomy #4
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Taxonomy Code | 171000000X
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Taxonomy Name | Military Health Care Provider
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License Number | 201601307RN
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License Number State | OR
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Taxonomy #5
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Taxonomy Code | 163WX0003X
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Taxonomy Name | Inpatient Obstetric Registered Nurse
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License Number | 201601307RN
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License Number State | OR
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