Shana Fishman Nicholson, RN

Primary specialty

Diabetes Educator Registered NurseTaxonomy code 163WD0400X

License

28200689A Issued in IN

Practice address

4000 Kresge Way
Louisville, KY 40207-4605

Phone

(502) 897-8831

NPI assigned

Aug 6, 2021

Last updated

Aug 6, 2021By 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

Other names 1

• Shana Frances Nicholson Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1628208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628208000000",
    "number": "1740954296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 KRESGE WAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074605",
            "telephone_number": "502-897-8831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 KRESGE WAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074605",
            "telephone_number": "502-897-8831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "SHANA",
        "middle_name": "FISHMAN",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-06",
        "last_updated": "2021-08-06",
        "certification_date": "2021-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "IN",
            "license": "28200689A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANA",
            "last_name": "NICHOLSON",
            "middle_name": "FRANCES",
            "credential": "RN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Anna L Nicholson, RBT
• Christine M Nicholson, LSW
• Elizabeth Nicholson, MS CCC/SLP
• Ellen Nicholson, PTA
• Jonisha Nicholson, LPCC
• Jacquelyn Marie Nickele
• Dana Lynnette Nickell, ARNP
• Bailey L Nickerson, RBT
• Emily Nicklies, PT, DPT
• Michael Carl Nicoson, M.D.

• Diabetes Educator Registered Nurse in Louisville, KY
• Providers in Louisville, KY by specialty
• Diabetes Educator Registered Nurse in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2021; 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.