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General NPI Number Information
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NPI Number | 1659462166
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Entity Type | Individual
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Provider Name | NIKOLE FUNK DO
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Gender | Female
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Dates
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Enumeration Date | 09/28/2006
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Last Update Date | 10/24/2025
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Provider Practice Location Address
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Address Line | 2452 SIR BARTON WAY STE 303
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City | LEXINGTON
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State | KY
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Zip | 40509-2826
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Country | US
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Telephone | 859-340-3233
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Fax | 855-998-8574
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Provider Business Mailing Address
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Address Line | PO BOX 40412
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City | BELFAST
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State | ME
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Zip | 04915-1255
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Country | US
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Telephone | 248-824-6500
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Fax | 855-618-6655
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 34008699
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 34008699
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License Number State | OH
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