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NPI Code Detail

MEDICARE: NICOLE P FALATIC DNP, FNP-C

MEDICARE: NICOLE P FALATIC DNP, FNP-C
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
1363LF0000XFamily Nurse Practitioner4704290114MI

General Provider Information

NPI Number : 1457986069
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE P FALATIC DNP, FNP-C
Provider Business Mailing Address
First Line : PO BOX 279
Second Line :
City : SHERIDAN
State : MI
Zip : 48884-0279
Country : US
Telephone Number : 989-291-5077
Fax Number : 989-291-5348
Provider Business Practice Location Address
First Line : 303 CONGRESS ST
Second Line :
City : SHERIDAN
State : MI
Zip : 48884-9215
Country : US
Telephone Number : 989-291-5077
Fax Number : 989-291-5348
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/04/2020
Last Update Date : 12/30/2020

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