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NPI Code Detail

MEDICARE: HEIDI E NISLY CPM

MEDICARE:   HEIDI E NISLY  CPM
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
1176B00000XMidwife99096TX

General Provider Information

NPI Number : 1578855946
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEIDI E NISLY CPM
Provider Business Mailing Address
First Line : 9101 W RED ROCK RD
Second Line :
City : PARTRIDGE
State : KS
Zip : 67566-9042
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 9101 W RED ROCK RD
Second Line :
City : PARTRIDGE
State : KS
Zip : 67566-9042
Country : US
Telephone Number : 620-899-2866
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2011
Last Update Date : 05/04/2011

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Directions to “ HEIDI E NISLY CPM” Practice Location

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