Nanette Ann Nichols
Individual provider Active NPI Licensed Practical Nurse · Coloma, MI
NPI 1558055087 · NPPES record last updated Jun 7, 2023
Key facts
- NPI
- 1558055087
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- 4703076697 (MI)
- Practice address
- 5100 Little Paw Paw Lake Rd Lot 1
Coloma, MI 49038-9504 - Phone
- (415) 819-6909
- NPI assigned
- Jun 7, 2023
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 4703076697 | MI | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 4703076697 | MI | Yes |
Addresses
Primary practice location
5100 Little Paw Paw Lake Rd Lot 1
Coloma, MI 49038-9504
Mailing address
5100 Little Paw Paw Lake Rd Lot 1
Coloma, MI 49038-9504
Other providers in Coloma, MI
- Samuel Robert Miller
- Lori Mizwicki
- Moss Chiropractic Clinic P.C.
- David Earl Moss
- Edwin Keith Newington
- Miriam Opara
- Orrison Rehabilitation Services, LLC
- Josefina Pena-Ogando
- Jeffrey T Postma
- Michelle Lynn Powell
All providers in Coloma, MI · Licensed Practical Nurse in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 7, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.