Individual
ALYSE NIKOLAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP, CNM
Contact information
Practice address
1608 S J ST, TACOMA, WA 98405-4930
(253) 274-7501
(253) 274-7926
Mailing address
1608 S J ST, TACOMA, WA 98405-4930
(253) 274-7501
(253) 274-7926
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN60436839
WA
363L00000X
Nurse Practitioner
AP60932557
WA
367A00000X
Advanced Practice Midwife
Primary
AP60932557
WA
367A00000X
Advanced Practice Midwife
AP60932559
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2132960
—
WA
Enumeration date
01/21/2016
Last updated
12/08/2020
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