NICOLE NISSEN
Nurse Practitioner - Family
Active
Individual
NPI: 1629569843
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Nurse Practitioner | 363L00000X | No | 209017442 (IL) |
| Nurse Practitioner - Family | 363LF0000X | Yes | 2018012260 (MO) |
Frequently Asked Questions
NPI 1629569843 is the National Provider Identifier for NICOLE NISSEN, a Nurse Practitioner - Family provider located in Waterloo, IL. This NPI was enumerated on May 23, 2018.
NICOLE NISSEN practices at 623 HAMACHER ST, Waterloo, IL 62298.
Quick Facts
- NPI
- 1629569843
- Type
- Individual
- Enumerated
- May 23, 2018
- Last Updated
- Apr 17, 2025
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