Provider Demographics
NPI:1285112276
Name:ALBERS, NICHOLE CHRISTINE (PNP)
Entity type:Individual
Prefix:MS
First Name:NICHOLE
Middle Name:CHRISTINE
Last Name:ALBERS
Suffix:
Gender:
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7412011
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60674-2011
Mailing Address - Country:US
Mailing Address - Phone:314-454-2358
Mailing Address - Fax:314-454-2009
Practice Address - Street 1:1 CHILDRENS PL
Practice Address - Street 2:DIV SURG CT PEDS, STE 2A
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1002
Practice Address - Country:US
Practice Address - Phone:314-454-2358
Practice Address - Fax:314-454-2009
Is Sole Proprietor?:No
Enumeration Date:2018-08-01
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018028144363LP0222X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0222XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics, Critical Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO420064018Medicaid