Provider Demographics
NPI:1568748655
Name:BRICE, NICOLE F (REGISTERED NURSE)
Entity Type:Individual
Prefix:MS
First Name:NICOLE
Middle Name:F
Last Name:BRICE
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:MS
Other - First Name:NICOLE
Other - Middle Name:F
Other - Last Name:BRICE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:4386 W DEER RUN DR APT 201
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53223-6402
Mailing Address - Country:US
Mailing Address - Phone:414-792-0812
Mailing Address - Fax:
Practice Address - Street 1:4386 W DEER RUN DR APT 201
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53223-6402
Practice Address - Country:US
Practice Address - Phone:414-792-0812
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-02
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI313971-031164W00000X
WI255857163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse