Individual
NICHOL SUZANNE HALVERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
625 9TH AVE STE 210, LONGVIEW, WA 98632-2465
(360) 501-3400
(360) 423-6862
Mailing address
625 9TH AVE, SUITE 210, LONGVIEW, WA 98632-2464
(360) 501-3400
(360) 423-5682
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP60538584
WA
363LF0000X
Family Nurse Practitioner
AP 60538584
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1033540919
—
WA
Enumeration date
12/03/2013
Last updated
06/23/2015
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