Provider Demographics
NPI:1346809639
Name:HUNTLEY, NICOLE M (MS APN ACCNS-AG RN)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:M
Last Name:HUNTLEY
Suffix:
Gender:F
Credentials:MS APN ACCNS-AG RN
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:M
Other - Last Name:BRAUN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSN, RN
Mailing Address - Street 1:12401 E 17TH AVE # 6-036
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80045-2548
Mailing Address - Country:US
Mailing Address - Phone:720-848-6649
Mailing Address - Fax:
Practice Address - Street 1:12401 E 17TH AVE # 6-036
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-2548
Practice Address - Country:US
Practice Address - Phone:720-848-6649
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-10
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0992219-CNS364SA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2100XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAcute Care