Provider Demographics
NPI:1508194085
Name:FELSING, NICOLE MARIE (FNP-BC)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:MARIE
Last Name:FELSING
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 779
Mailing Address - Street 2:
Mailing Address - City:TAWAS CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48764-0779
Mailing Address - Country:US
Mailing Address - Phone:989-799-8712
Mailing Address - Fax:989-791-4216
Practice Address - Street 1:4677 TOWNE CTR
Practice Address - Street 2:SUITE 301
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48604-2846
Practice Address - Country:US
Practice Address - Phone:989-799-8712
Practice Address - Fax:989-791-4216
Is Sole Proprietor?:No
Enumeration Date:2009-11-23
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704248446363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner