Provider Demographics
NPI:1174255939
Name:HALE, NICHOLE LEE (DNP, ARNP, FNP-C)
Entity Type:Individual
Prefix:
First Name:NICHOLE
Middle Name:LEE
Last Name:HALE
Suffix:
Gender:F
Credentials:DNP, ARNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3900 MANHEIM RD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64110-1310
Mailing Address - Country:US
Mailing Address - Phone:316-305-8664
Mailing Address - Fax:913-588-9254
Practice Address - Street 1:10777 NALL AVE STE 210
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211-1327
Practice Address - Country:US
Practice Address - Phone:913-588-8553
Practice Address - Fax:913-588-9254
Is Sole Proprietor?:No
Enumeration Date:2022-06-29
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-81334-081363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner