Individual
MS. NICOLE N RANSBOTTOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP
Contact information
Practice address
4400 NE HALSEY ST STE 102, PORTLAND, OR 97213-1545
(503) 962-1000
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
202201786RN
OR
363LA2100X
Acute Care Nurse Practitioner
Primary
202212418NP-PP
OR
363LG0600X
Gerontology Nurse Practitioner
202212418NP-PP
OR
Other
Enumeration date
07/13/2022
Last updated
04/25/2023
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