Provider Demographics
NPI:1801084785
Name:GETTINGS, NIKOLE DIANE (CNM)
Entity type:Individual
Prefix:MS
First Name:NIKOLE
Middle Name:DIANE
Last Name:GETTINGS
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 1:7945 WOLF RIVER BLVD
Mailing Address - Street 2:ATTENTION STEPHANIE GAUT
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-1762
Mailing Address - Country:US
Mailing Address - Phone:901-488-3417
Mailing Address - Fax:901-922-6774
Practice Address - Street 1:7945 WOLF RIVER BLVD
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-1762
Practice Address - Country:US
Practice Address - Phone:901-488-3417
Practice Address - Fax:901-922-6774
Is Sole Proprietor?:No
Enumeration Date:2007-10-04
Last Update Date:2016-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000012711367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
PTAN1031425805OtherPTAN
TNQ001332Medicaid