Provider Demographics
NPI:1073926671
Name:RING, NICOLE
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:RING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1675 HONEY CREEK CIRCLE
Mailing Address - Street 2:P.O. BOX 61
Mailing Address - City:PLAIN
Mailing Address - State:WI
Mailing Address - Zip Code:53577
Mailing Address - Country:US
Mailing Address - Phone:608-588-4033
Mailing Address - Fax:
Practice Address - Street 1:1675 HONEY CREEK CIRCLE
Practice Address - Street 2:
Practice Address - City:PLAIN
Practice Address - State:WI
Practice Address - Zip Code:53577
Practice Address - Country:US
Practice Address - Phone:608-588-4033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-11
Last Update Date:2014-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI318143-31164W00000X
WINA302238376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No376K00000XNursing Service Related ProvidersNurse's Aide