Provider Demographics
NPI:1528529872
Name:NIKOLAAS, SHEILA B (HIS/DEALER)
Entity type:Individual
Prefix:
First Name:SHEILA
Middle Name:B
Last Name:NIKOLAAS
Suffix:
Gender:F
Credentials:HIS/DEALER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:287 MOLLIE LN
Mailing Address - Street 2:
Mailing Address - City:PLAINWELL
Mailing Address - State:MI
Mailing Address - Zip Code:49080-9588
Mailing Address - Country:US
Mailing Address - Phone:231-920-1332
Mailing Address - Fax:
Practice Address - Street 1:352 12TH ST STE 5
Practice Address - Street 2:
Practice Address - City:PLAINWELL
Practice Address - State:MI
Practice Address - Zip Code:49080-1154
Practice Address - Country:US
Practice Address - Phone:231-920-1332
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-28
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI3501005128237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist