Provider Demographics
NPI:1790423887
Name:HAUSER, NICOLE M (MSN, CNP, FNP-BC)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:M
Last Name:HAUSER
Suffix:
Gender:F
Credentials:MSN, CNP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7443 JACKMAN RD
Mailing Address - Street 2:
Mailing Address - City:TEMPERANCE
Mailing Address - State:MI
Mailing Address - Zip Code:48182-9223
Mailing Address - Country:US
Mailing Address - Phone:734-850-0100
Mailing Address - Fax:888-491-3525
Practice Address - Street 1:7443 JACKMAN RD
Practice Address - Street 2:
Practice Address - City:TEMPERANCE
Practice Address - State:MI
Practice Address - Zip Code:48182-9223
Practice Address - Country:US
Practice Address - Phone:734-850-0100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-26
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.363861363LF0000X
MI4704392991363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily