Provider Demographics
NPI:1114190972
Name:WHITLATCH, NICOLE LEMIEUX (MD)
Entity Type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:LEMIEUX
Last Name:WHITLATCH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:NICOLE
Other - Middle Name:AUDET
Other - Last Name:LEMIEUX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 7555
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95927-7555
Mailing Address - Country:US
Mailing Address - Phone:530-332-4530
Mailing Address - Fax:530-893-6984
Practice Address - Street 1:1720 ESPLANADE
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-3315
Practice Address - Country:US
Practice Address - Phone:530-332-4530
Practice Address - Fax:530-893-6984
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-11
Last Update Date:2016-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA108945207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology