Provider Demographics
NPI:1841645140
Name:BEHM, NICOLE (MD)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:BEHM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:U.S. NAVAL HOSPITAL YOKOSUKA
Mailing Address - Street 2:
Mailing Address - City:YOKOSUKA
Mailing Address - State:JAPAN
Mailing Address - Zip Code:96350-1600
Mailing Address - Country:JP
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:U.S. NAVAL HOSPITAL YOKOSUKA
Practice Address - Street 2:
Practice Address - City:YOKOSUKA
Practice Address - State:JAPAN
Practice Address - Zip Code:96350-1600
Practice Address - Country:JP
Practice Address - Phone:011-814-6816
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101264687208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics