Provider Demographics
NPI:1427378090
Name:GETZEL, NICOLE J (DO)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:J
Last Name:GETZEL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:
Other - Last Name:LICKING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 9049
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-9049
Mailing Address - Country:US
Mailing Address - Phone:303-415-8800
Mailing Address - Fax:303-415-8801
Practice Address - Street 1:4801 RIVERBEND RD STE 200
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-2613
Practice Address - Country:US
Practice Address - Phone:303-415-8800
Practice Address - Fax:303-415-8801
Is Sole Proprietor?:No
Enumeration Date:2010-06-07
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOT013596207R00000X, 2084N0400X
ORDO1670092084N0400X
WY13331A2084N0400X
VA0116023343390200000X
CODR.00565012084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program