Provider Demographics
NPI:1083326318
Name:NAGEL, NICOLE YVETTE (CD/PCD, CLC)
Entity Type:Individual
Prefix:MS
First Name:NICOLE
Middle Name:YVETTE
Last Name:NAGEL
Suffix:
Gender:F
Credentials:CD/PCD, CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2550 N 11 MILE RD
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48657-9747
Mailing Address - Country:US
Mailing Address - Phone:989-488-7456
Mailing Address - Fax:
Practice Address - Street 1:2550 N 11 MILE RD
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:MI
Practice Address - Zip Code:48657-9747
Practice Address - Country:US
Practice Address - Phone:989-488-7456
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-19
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7211-52374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula