Provider Demographics
NPI:1386338671
Name:THORELL, NICOLE C (APRN)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:C
Last Name:THORELL
Suffix:
Gender:F
Credentials:APRN
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 980
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:NE
Mailing Address - Zip Code:68850-0980
Mailing Address - Country:US
Mailing Address - Phone:308-324-5651
Mailing Address - Fax:308-324-8359
Practice Address - Street 1:1201 N ERIE ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:NE
Practice Address - Zip Code:68850-1560
Practice Address - Country:US
Practice Address - Phone:308-324-5651
Practice Address - Fax:308-324-8359
Is Sole Proprietor?:No
Enumeration Date:2023-06-08
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE114810363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner