Provider Demographics
NPI:1760967384
Name:LAUX, NICHOLE A (CNP)
Entity Type:Individual
Prefix:
First Name:NICHOLE
Middle Name:A
Last Name:LAUX
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:NICHOLE
Other - Middle Name:A
Other - Last Name:WHINERY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2732 N ALVERNON WAY
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-1804
Mailing Address - Country:US
Mailing Address - Phone:520-382-3330
Mailing Address - Fax:520-382-3340
Practice Address - Street 1:2732 N ALVERNON WAY
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-1804
Practice Address - Country:US
Practice Address - Phone:520-382-3330
Practice Address - Fax:520-382-3340
Is Sole Proprietor?:No
Enumeration Date:2018-09-28
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ217998363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ217998OtherCERTIFIED NURSE PRACTITIONER LICENSE