Provider Demographics
NPI:1871266692
Name:BARKHAUS, NICHOLE LEA (RN)
Entity Type:Individual
Prefix:
First Name:NICHOLE
Middle Name:LEA
Last Name:BARKHAUS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:607 8TH ST SW STE B
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:IA
Mailing Address - Zip Code:50009-2315
Mailing Address - Country:US
Mailing Address - Phone:515-979-7800
Mailing Address - Fax:
Practice Address - Street 1:607 8TH ST SW STE B
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:IA
Practice Address - Zip Code:50009-2315
Practice Address - Country:US
Practice Address - Phone:515-979-7800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-28
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA107357163WN1003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WN1003XNursing Service ProvidersRegistered NurseNutrition Support