Provider Demographics
NPI:1548943327
Name:UHLAND, NICHOLE (PT)
Entity type:Individual
Prefix:
First Name:NICHOLE
Middle Name:
Last Name:UHLAND
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8756 W VILLA LINDO DR
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85383-1834
Mailing Address - Country:US
Mailing Address - Phone:623-512-3772
Mailing Address - Fax:
Practice Address - Street 1:19303 N NEW TRADITION RD
Practice Address - Street 2:
Practice Address - City:SUN CITY WEST
Practice Address - State:AZ
Practice Address - Zip Code:85375-3806
Practice Address - Country:US
Practice Address - Phone:623-887-4743
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-09
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ6043225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist