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NPI Code Detail

MEDICARE: NICOLE LYNN ATWELL M.ED

MEDICARE:   NICOLE LYNN ATWELL  M.ED
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator0000077417NV

General Provider Information

NPI Number : 1174814255
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE LYNN ATWELL M.ED
Provider Business Mailing Address
First Line : 516 BACHELOR BUTTON ST
Second Line :
City : LAS VEGAS
State : NV
Zip : 89138-6077
Country : US
Telephone Number : 702-290-1811
Fax Number :
Provider Business Practice Location Address
First Line : 516 BACHELOR BUTTON ST
Second Line :
City : LAS VEGAS
State : NV
Zip : 89138-6077
Country : US
Telephone Number : 702-290-1811
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/25/2011
Last Update Date : 04/25/2011

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Directions to “ NICOLE LYNN ATWELL M.ED” Practice Location

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