Individual provider · Type 1 NPI
Nicole Mateo Licup Nam, NP
Primary Care Nurse Practitioner · Los Angeles, CA
NPI number
1538827985
Active
Practice location
11301 Wilshire Blvd # 117
Los Angeles, CA 90073-1003
Mailing address
11301 Wilshire Blvd
Los Angeles, CA 90073-1003
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Registered Nurse | 163W00000X | 95085049 (CA) |
| Primary Care Nurse Practitioner Primary | 363LP2300X | 95015421 (CA) |
Primary Care Nurse Practitioner: Definition to come...
8 other providers at this address
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- Agnes Soriano Wallbom, MD, M.S.Physical Medicine & Rehabilitation Physician Los Angeles, CA NPI 1316976509
- Berthel Powell, BA/RKTKinesiotherapist Los Angeles, CA NPI 1326125618
- David Arthur Benton, DOPhysical Medicine & Rehabilitation Physician Los Angeles, CA NPI 1790915262
- Deborah Lynn Cornwell, OTR/LOccupational Therapist Los Angeles, CA NPI 1922268960
- Melissa Erin Phuphanich, MD, MSStudent in an Organized Health Care Education/Training Program Los Angeles, CA NPI 1497252837
- Ryan McCarty, MDPain Medicine (Physical Medicine & Rehabilitation) Physician Los Angeles, CA NPI 1225482821
- Shana Schuller Friedman, OTROccupational Therapist Los Angeles, CA NPI 1457447708
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- Evelyn Schwabe, NURSE PRACTITIONERPrimary Care Nurse Practitioner Los Angeles, CA NPI 1033645312
- Nistal Cassandra Aguilar, FNP-BCPrimary Care Nurse Practitioner Los Angeles, CA NPI 1053216515
- Grace A. Rogers, RN, FNPPrimary Care Nurse Practitioner Los Angeles, CA NPI 1073259214
- Casey James Welk, AGNP-CPrimary Care Nurse Practitioner Los Angeles, CA NPI 1083104582
About NPI 1538827985
Nicole Mateo Licup Nam, NP's National Provider Identifier is 1538827985, issued on Dec 2, 2021. The primary taxonomy on file is Primary Care Nurse Practitioner (363LP2300X), and the practice location is in Los Angeles, CA. The record was last updated on Feb 8, 2022.