Provider Demographics
NPI:1912493735
Name:VROMAN, NICOLE (MS CFY-SLP)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:VROMAN
Suffix:
Gender:F
Credentials:MS CFY-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 S 30TH ST
Mailing Address - Street 2:
Mailing Address - City:MANITOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:54220-4305
Mailing Address - Country:US
Mailing Address - Phone:608-333-9301
Mailing Address - Fax:
Practice Address - Street 1:2900 CURRY LN
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54311-5857
Practice Address - Country:US
Practice Address - Phone:920-468-1161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-04
Last Update Date:2018-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4668-154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist