Active NPI
Nicole Wallin
- Lactation Consultant (Registered Nurse)
- Bellevue, NE
National Provider Identifier
1740640317
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Lactation Consultant (Registered Nurse)
- License
- 65212
- Practice address
- 4802 Shannon Dr
Bellevue, NE 68133-4711 - Phone
- (402) 955-7600
- Fax
- (402) 955-7601
- NPI assigned
- Feb 25, 2016
- 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 |
|---|---|---|---|---|
| Lactation Consultant (Registered Nurse) | 163WL0100X | 65212 | NE | Primary |
Addresses
Primary practice location
4802 Shannon Dr
Bellevue, NE 68133-4711
Mailing address
8200 Dodge St
Omaha, NE 68114-4113
Phone (402) 955-5400
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 |
|---|---|---|---|
| 65212 | NE | MD | Lactation Consultant (Registered Nurse) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1456358400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1456358400000",
"number": "1740640317",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8200 DODGE ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681144113",
"telephone_number": "402-955-5400",
"fax_number": "402-955-3674"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4802 SHANNON DR",
"city": "BELLEVUE",
"state": "NE",
"postal_code": "681334711",
"telephone_number": "402-955-7600",
"fax_number": "402-955-7601"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALLIN",
"first_name": "NICOLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-02-25",
"last_updated": "2016-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "163WL0100X",
"taxonomy_group": "",
"desc": "Registered Nurse, Lactation Consultant",
"state": "NE",
"license": "65212",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bellevue, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.