Nicole Lynn Real, is a
Licensed Practical Nurse based in Mountain Home, Idaho. Nicole Lynn Real is licensed to practice in Idaho (license number 71011) and her current practice location is
815 N 6th E, Mountain Home, Idaho. She can be reached at her office (for appointments etc.) via phone at
(208) 580-2001.
NPI number for Nicole Lynn Real is 1508567694 and her current mailing address is 815 N 6th E, Mountain Home, Idaho. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1508567694.
Provider's Profile
| Full Name | Nicole Lynn Real |
|---|
| Gender | Female |
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| Speciality | Licensed Practical Nurse |
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| Location | 815 N 6th E, Mountain Home, Idaho |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1508567694
- Provider Enumeration Date: 03/15/2023
- Last Update Date: 03/15/2023
Medical Identifiers
Medical identifiers for Nicole Lynn Real such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1508567694 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 164W00000X | Licensed Practical Nurse | 71011 (Idaho) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Nicole Lynn Real is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Nicole Lynn Real,
815 N 6th E,
Mountain Home, ID 83647-2207
Ph: (208) 580-2001 | Nicole Lynn Real,
815 N 6th E,
Mountain Home, ID 83647-2207
Ph: (208) 580-2001 |
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