Provider Demographics
NPI:1982926549
Name:KIEHN, NICOLE M (RN)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:M
Last Name:KIEHN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:SHEDRICK
Other - Middle Name:
Other - Last Name:HOWARD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1311 W 21ST ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-1601
Mailing Address - Country:US
Mailing Address - Phone:509-366-0512
Mailing Address - Fax:
Practice Address - Street 1:1311 W 21ST ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-1601
Practice Address - Country:US
Practice Address - Phone:509-366-0512
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-24
Last Update Date:2010-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO186993163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice