Nicole Lynn Real

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

71011 Issued in ID

Practice address

815 N 6TH E
Mountain Home, ID 83647-2207

Phone

(208) 580-2001

NPI assigned

Mar 15, 2023

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1678838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678838400000",
    "number": "1508567694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 N 6TH E",
            "city": "MOUNTAIN HOME",
            "state": "ID",
            "postal_code": "836472207",
            "telephone_number": "208-580-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 N 6TH E",
            "city": "MOUNTAIN HOME",
            "state": "ID",
            "postal_code": "836472207",
            "telephone_number": "208-580-2001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REAL",
        "first_name": "NICOLE",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-15",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "ID",
            "license": "71011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Katrina Price, BSW
• Jonathan A Price, CADC
• Nathan Curran Price, O.D.
• Rhonda Kay Pyper
• William Arthur Rayl, DC
• Resilient Chiropractic PLLC
• Richard Fredrick Starkey MD
• Susan Riedinger, LMSW
• Steve K Riley, MA, LPC
• Layne D. Roberts, D.O.

• Licensed Practical Nurse in Mountain Home, ID
• Providers in Mountain Home, ID by specialty
• Licensed Practical Nurse in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.