Provider Demographics
NPI:1730197971
Name:SCHLOSSER, NICOLE MARIE (ARNP)
Entity type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:MARIE
Last Name:SCHLOSSER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2442 MEINEN CT
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52002-2787
Mailing Address - Country:US
Mailing Address - Phone:563-556-6292
Mailing Address - Fax:563-588-6286
Practice Address - Street 1:2442 MEINEN CT
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52002-2787
Practice Address - Country:US
Practice Address - Phone:563-556-6292
Practice Address - Fax:563-588-6286
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA-100449363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1458521Medicaid
3674001OtherMEDICARE ID
IA1458521Medicaid
3674001OtherMEDICARE ID