Individual
NICOLE HERBEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
965 MATTOX DR, SULLIVAN, MO 63080-2365
(573) 860-6000
Mailing address
2106 COUNTY LINE RD, ROSEBUD, MO 63091-1900
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2019038523
MO
363L00000X
Nurse Practitioner
Primary
2025045575
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
041558099
RN
IL
01
—
2019038523
RN
MO
Enumeration date
07/28/2025
Last updated
01/08/2026
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