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NPI Code Detail

MEDICARE: NICHOLE L NELSON

MEDICARE: NICHOLE L NELSON
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
1101Y00000XCounselor

General Provider Information

NPI Number : 1760795074
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICHOLE L NELSON
Provider Business Mailing Address
First Line : 605 W BRAND ST
Second Line :
City : DURAND
State : MI
Zip : 48429-1120
Country : US
Telephone Number : 810-496-4955
Fax Number :
Provider Business Practice Location Address
First Line : 1402 S SAGINAW ST
Second Line :
City : FLINT
State : MI
Zip : 48503-3705
Country : US
Telephone Number : 810-496-5772
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/16/2010
Last Update Date : 01/25/2024

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Directions to “ NICHOLE L NELSON ” Practice Location

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