Provider Demographics
NPI:1598421091
Name:BILLAU, NICHOLE JEAN (RN)
Entity Type:Individual
Prefix:MRS
First Name:NICHOLE
Middle Name:JEAN
Last Name:BILLAU
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:NICHOLE
Other - Middle Name:JEAN
Other - Last Name:KOCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:706 NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49017-3231
Mailing Address - Country:US
Mailing Address - Phone:269-224-0060
Mailing Address - Fax:
Practice Address - Street 1:706 NORTH AVE
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49017-3231
Practice Address - Country:US
Practice Address - Phone:269-224-0060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-10
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704354942163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse