Provider Demographics
NPI:1104944891
Name:NEUSCHLER, NICOLE A (MD)
Entity type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:A
Last Name:NEUSCHLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4500 E CHERRY CREEK SOUTH DR STE 600
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CO
Mailing Address - Zip Code:80246-1500
Mailing Address - Country:US
Mailing Address - Phone:303-355-3000
Mailing Address - Fax:
Practice Address - Street 1:4500 E CHERRY CREEK SOUTH DR STE 600
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CO
Practice Address - Zip Code:80246-1500
Practice Address - Country:US
Practice Address - Phone:303-355-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301081666390200000X
CO46742207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO62523236Medicaid
MI5315013725OtherCONTROLLED SUBSTANCE LICE
CO019319OtherKAISER COMMERCIAL NUMBER
CO019319OtherKAISER COMMERCIAL NUMBER