Individual
MS. NICOLE LINN ACOSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Taxonomy
Speciality
Code
Description
License number
State
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
Primary
201866339RN
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201806339RN
OREGON STATE BOARD OF NURSING
OR
Enumeration date
09/14/2018
Last updated
09/14/2018
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