Provider Demographics
NPI:1043899156
Name:LINGLE, NICOLE PAIGE (CRNA)
Entity Type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:PAIGE
Last Name:LINGLE
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1724 TRAILWOOD DR
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-2060
Mailing Address - Country:US
Mailing Address - Phone:218-730-7115
Mailing Address - Fax:
Practice Address - Street 1:1135 ORANGE ARBOUR TRL APT 317
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-5314
Practice Address - Country:US
Practice Address - Phone:218-730-7115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-06
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COC-APN.0100867-C-CRNA367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered