Basic Information
Provider Information
NPI: 1235406034
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: STRICKLAND
FirstName: NICOLE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: APRN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 159
Address2:  
City: MUNFORDVILLE
State: KY
PostalCode: 427650159
CountryCode: US
TelephoneNumber: 2705241201
FaxNumber: 2705241202
Practice Location
Address1: 950 MAIN ST.
Address2:  
City: MUNFORDVILLE
State: KY
PostalCode: 42765
CountryCode: US
TelephoneNumber: 2705241201
FaxNumber: 2705241202
Other Information
ProviderEnumerationDate: 11/22/2011
LastUpdateDate: 11/20/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000X3007202KYY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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