Provider Demographics
NPI:1104668805
Name:CALDWELL, NICOLE (BSN, RN)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:CALDWELL
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1390 MARKET ST STE 200
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-5404
Mailing Address - Country:US
Mailing Address - Phone:813-445-3296
Mailing Address - Fax:844-251-4889
Practice Address - Street 1:800 ADAMS LN
Practice Address - Street 2:
Practice Address - City:KAUFMAN
Practice Address - State:TX
Practice Address - Zip Code:75142-2245
Practice Address - Country:US
Practice Address - Phone:800-504-5360
Practice Address - Fax:844-251-4889
Is Sole Proprietor?:No
Enumeration Date:2024-06-12
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX939370163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse