NICOLE M ERVIN ARNP NPI 1881033439

NPI Information

NPI: 1881033439
Provider Name: NICOLE M ERVIN, ARNP
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

PECOS Registration: Yes

Address:
1110 SE ALDER STREET #301
PORTLAND, OR
ZIP 97214
Phone: (971) 328-1565
Get Directions

Nicole M Ervin, ARNP is a psychiatric/mental health nurse practitioner in Portland, OR. Nicole M Ervin, ARNP NPI is 1881033439. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1110 SE ALDER STREET #301
PORTLAND, OR
ZIP 97214
Phone: (971) 328-1565
Fax: (206) 385-7376

The NPI 1881033439 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/17/2013 and was last updated on 10/12/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	201350111NP	OREGON	No
2	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	AP60579125	WASHINGTON	No
3	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	202006403NP-PP	OREGON	Yes
4	163WP0808X	Registered Nurse	Psychiatric/Mental Health	RN60568890	WASHINGTON	No
5	363L00000X	Nurse Practitioner		201341028RN	OREGON	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1881033439	MEDICAID	WASHINGTON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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