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NPI Code Detail

MEDICARE: NICOLETTE WHITE

MEDICARE: NICOLETTE WHITE
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
1235Z00000XSpeech-Language Pathologist7380-154WI

General Provider Information

NPI Number : 1205760394
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLETTE WHITE
Provider Business Mailing Address
First Line : 322 N 18TH AVE
Second Line :
City : STURGEON BAY
State : WI
Zip : 54235-3212
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 200 N 7TH AVE
Second Line :
City : STURGEON BAY
State : WI
Zip : 54235-1708
Country : US
Telephone Number : 920-743-6274
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2026
Last Update Date : 06/11/2026

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Directions to “ NICOLETTE WHITE ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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