Individual provider Active NPI

Nicole Harrelson, RN

  • School Registered Nurse
  • Rohnert Park, CA
National Provider Identifier
1902625130
Registry record updated Oct 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Registered NurseTaxonomy code 163WS0200X
License
754427 Issued in CA
Practice address
1400 Magnolia Ave
Rohnert Park, CA 94928-8129
Phone
(707) 792-4531
NPI assigned
Oct 4, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X 754427 CA Primary

Addresses

Primary practice location

1400 Magnolia Ave
Rohnert Park, CA 94928-8129

Mailing address

7521 Windward Dr
Rohnert Park, CA 94928-4086
Phone (949) 637-0500

Other practice location 1

5154 Snyder Ln
Rohnert Park, CA 94928-2943
Phone (707) 588-5600

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
754427CAMDSchool Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1728000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728000000000",
    "number": "1902625130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7521 WINDWARD DR",
            "city": "ROHNERT PARK",
            "state": "CA",
            "postal_code": "949284086",
            "telephone_number": "949-637-0500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 MAGNOLIA AVE",
            "city": "ROHNERT PARK",
            "state": "CA",
            "postal_code": "949288129",
            "telephone_number": "707-792-4531"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5154 Snyder Ln",
            "address_purpose": "LOCATION",
            "city": "Rohnert Park",
            "state": "CA",
            "postal_code": "949282943",
            "country_code": "US",
            "telephone_number": "707-588-5600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRELSON",
        "first_name": "NICOLE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-04",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "CA",
            "license": "754427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rohnert Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2024; 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.