Individual
MRS. NICOLE L RALSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGNP-C
Contact information
Practice address
5301 E GRANT RD, TUCSON, AZ 85712-2805
(520) 324-1205
(520) 324-3650
Mailing address
PO BOX 31235, TUCSON, AZ 85751-1235
(520) 324-2308
Taxonomy
Speciality
Code
Description
License number
State
163WH1000X
Hospice Registered Nurse
RN113296
MD
363LA2200X
Adult Health Nurse Practitioner
Primary
AP8413
AZ
363LG0600X
Gerontology Nurse Practitioner
AP8413
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
489037
—
AZ
Enumeration date
11/26/2015
Last updated
09/16/2021
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