Nanette Ann Nichols

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

4703076697 Issued in MI

Practice address

5100 Little Paw Paw Lake Rd Lot 1
Coloma, MI 49038-9504

Phone

(415) 819-6909

NPI assigned

Jun 7, 2023

Last updated

Jun 7, 2023By the provider in NPPES

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": "1686096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686096000000",
    "number": "1558055087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 LITTLE PAW PAW LAKE RD LOT 1",
            "city": "COLOMA",
            "state": "MI",
            "postal_code": "490389504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 LITTLE PAW PAW LAKE RD LOT 1",
            "city": "COLOMA",
            "state": "MI",
            "postal_code": "490389504",
            "telephone_number": "415-819-6909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "NANETTE",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-07",
        "last_updated": "2023-06-07",
        "certification_date": "2023-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MI",
            "license": "4703076697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samuel Robert Miller, LMT
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• David Earl Moss, DC
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• Kelsey Nimtz
• Miriam Opara, PHARMD
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• Josefina Pena-Ogando, LCSW
• Jeffrey T Postma, DO

• Licensed Practical Nurse in Coloma, MI
• Providers in Coloma, MI by specialty
• Licensed Practical Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 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.