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NPI Code Detail

MEDICARE: NICOLE ANNE NICHOLS APN-CNP

MEDICARE:   NICOLE ANNE NICHOLS  APN-CNP
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
1363L00000XNurse Practitioner209029043IL

General Provider Information

NPI Number : 1912775024
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE ANNE NICHOLS APN-CNP
Provider Business Mailing Address
First Line : 880 W CENTRAL RD STE 4400
Second Line :
City : ARLINGTON HEIGHTS
State : IL
Zip : 60005-2386
Country : US
Telephone Number : 847-483-9400
Fax Number : 847-483-9426
Provider Business Practice Location Address
First Line : 880 W CENTRAL RD STE 4400
Second Line :
City : ARLINGTON HEIGHTS
State : IL
Zip : 60005-2386
Country : US
Telephone Number : 847-493-9400
Fax Number : 847-483-9426
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/18/2023
Last Update Date : 02/26/2024

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Directions to “ NICOLE ANNE NICHOLS APN-CNP” Practice Location

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