Provider Demographics
NPI:1699109645
Name:NASSIF, NICHOLE E (DNP)
Entity type:Individual
Prefix:DR
First Name:NICHOLE
Middle Name:E
Last Name:NASSIF
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:281 N ROOSEVELT AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85226-2620
Mailing Address - Country:US
Mailing Address - Phone:602-283-7474
Mailing Address - Fax:
Practice Address - Street 1:281 N ROOSEVELT AVE STE 1
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85226-2620
Practice Address - Country:US
Practice Address - Phone:602-283-7474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024171138363LF0000X
AZAP8805363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily