Provider Demographics
NPI:1659635464
Name:THURMAN, NICOLE E (FNP)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:E
Last Name:THURMAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:E
Other - Last Name:MCNICOL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1101 N CENTRAL AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85004-1844
Mailing Address - Country:US
Mailing Address - Phone:602-344-6550
Mailing Address - Fax:
Practice Address - Street 1:1101 N CENTRAL AVE STE 204
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85004-1844
Practice Address - Country:US
Practice Address - Phone:602-344-6550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-26
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN144954163W00000X
AZAP4534363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse