Provider Demographics
NPI:1184702433
Name:TODD, NICCOLE (RN)
Entity type:Individual
Prefix:
First Name:NICCOLE
Middle Name:
Last Name:TODD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:NICCOLE
Other - Middle Name:
Other - Last Name:MAPES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:11686 DENALI TRL
Mailing Address - Street 2:
Mailing Address - City:PEYTON
Mailing Address - State:CO
Mailing Address - Zip Code:80831-8479
Mailing Address - Country:US
Mailing Address - Phone:719-291-6174
Mailing Address - Fax:
Practice Address - Street 1:11686 DENALI TRL
Practice Address - Street 2:
Practice Address - City:PEYTON
Practice Address - State:CO
Practice Address - Zip Code:80831-8479
Practice Address - Country:US
Practice Address - Phone:719-428-3268
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2014-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health