Shila Nichols, NLP PRACTITIONER

Individual provider Active NPI Health & Wellness Coach · Jasper, MO

NPI 1043070022 · NPPES record last updated May 13, 2024

Key facts

NPI
1043070022
Entity type
Individual (NPI type 1)
Primary specialty
Health & Wellness Coach 171400000X
Practice address
101 W 4TH St
Jasper, MO 64755
Phone
(417) 483-0295
NPI assigned
Mar 19, 2024
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
6222CAMDPrevention Professional

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Prevention Professional 405300000X 6222 CA
Health & Wellness Coach 171400000X Yes

Addresses

Primary practice location

101 W 4TH St
Jasper, MO 64755

Mailing address

PO Box 75
Oronogo, MO 64855-0075
Phone (417) 483-0295

Other providers in Jasper, MO

All providers in Jasper, MO · Health & Wellness Coach in Missouri

Sources for this page

Verify at the official NPI Registry.