Individual provider · Type 1 NPI

Nicole Irene Back

Family Nurse Practitioner · Waterford, MI

NPI number 1013756576 Active

Practice location

5758 Cooley Lake Rd
Waterford, MI 48327-3073

Specialties and licenses

TaxonomyCodeLicense
Registered Nurse 163W00000X4704247636 (MI)
Family Nurse Practitioner Primary 363LF0000X4704247636 (MI)

Family Nurse Practitioner: Definition to come...

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About NPI 1013756576

Nicole Irene Back's National Provider Identifier is 1013756576, issued on May 23, 2024. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Waterford, MI. The record was last updated on Mar 6, 2025.