Provider Demographics
NPI:1134104185
Name:NIKKEL, MONTE (CNM)
Entity type:Individual
Prefix:
First Name:MONTE
Middle Name:
Last Name:NIKKEL
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 ROUTE108
Mailing Address - Street 2:
Mailing Address - City:SOMERSWORTH
Mailing Address - State:NH
Mailing Address - Zip Code:03878-1522
Mailing Address - Country:US
Mailing Address - Phone:603-953-0065
Mailing Address - Fax:603-953-0066
Practice Address - Street 1:311 ROUTE108
Practice Address - Street 2:
Practice Address - City:SOMERSWORTH
Practice Address - State:NH
Practice Address - Zip Code:03878-1522
Practice Address - Country:US
Practice Address - Phone:603-953-0065
Practice Address - Fax:603-953-0066
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH047848-21367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH2666524OtherCIGNA
NH30343434Medicaid
NHRE8184Medicare ID - Type Unspecified
NH30343434Medicaid