Individual
NICOLE HAINLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP, FNP
Contact information
Practice address
9205 SW BARNES RD, PORTLAND, OR 97225-6603
(503) 215-2906
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
201150145NP
OR
363LA2100X
Acute Care Nurse Practitioner
201150145NP
OR
363LA2100X
Acute Care Nurse Practitioner
201809639NP
OR
363LF0000X
Family Nurse Practitioner
201150145NP
OR
363LF0000X
Family Nurse Practitioner
336624
NY
363LG0600X
Gerontology Nurse Practitioner
Primary
201150145NP
OR
Other
Enumeration date
02/02/2011
Last updated
03/11/2021
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