Active NPI
Nicole Diann Lullman
- Counselor
- Des Moines, IA
National Provider Identifier
1427336825
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 08116
- Practice address
- 1409 Clark St
Des Moines, IA 50314-1964 - Phone
- (515) 643-6554
- Fax
- (515) 643-6555
- NPI assigned
- Aug 2, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 08116 | IA | Primary |
Addresses
Primary practice location
1409 Clark St
Des Moines, IA 50314-1964
Mailing address
1409 Clark St
Des Moines, IA 50314-1964
Phone (515) 643-6554
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 08116 | IA | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1312243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1312243200000",
"number": "1427336825",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1409 CLARK ST",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503141964",
"telephone_number": "515-643-6554",
"fax_number": "515-643-6555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1409 CLARK ST",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503141964",
"telephone_number": "515-643-6554",
"fax_number": "515-643-6555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LULLMAN",
"first_name": "NICOLE",
"middle_name": "DIANN",
"name_prefix": "Miss",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-08-02",
"last_updated": "2011-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "IA",
"license": "08116",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Des Moines, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.