NICOLE THEODORA PETTWAY LPN
NPI 1891091773
Licensed Practical Nurse in Detroit, MI

Q: What is Nicole Pettway's NPI number?

The NPI number for Nicole Pettway is 1891091773. It was assigned to this individual provider in the NPPES registry on February 10, 2011.

Q: What is Nicole Pettway's specialty?

The primary specialty registered for this NPI is Licensed Practical Nurse with taxonomy code 164W00000X.

Q: When was this NPI record last updated?

The NPPES record for Nicole Pettway was last updated on February 10, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since February 10, 2011

20201 ASBURY PARK ST, DETROIT, MI 48235(313) 826-4449 Get Directions Write a Review

NPPES record last updated: February 10, 2011. Verified against the NPPES registry weekly; last sync: October 04, 2026.

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About Nicole Theodora Pettway Lpn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NICOLE THEODORA PETTWAY LPN (NPI 1891091773) is an individual licensed practical nurse in Detroit, Michigan, licensed in Michigan (4703101683) and active in the NPI registry since February 2011.

NPPES Registry Identity

NPI1891091773

Entity TypeIndividualFemale

Primary Taxonomy164W00000X

Provider Legal NameNICOLE THEODORA PETTWAYCredential: LPN

Location Address20201 ASBURY PARK STDetroit, MI 48235

Mailing Address20201 Asbury ParkDetroit, MI 48235-2102 · (313) 826-4449

Phone(313) 826-4449

Sole ProprietorYes

Enumeration DateFebruary 10, 2011

✔ NPI 1891091773 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyLicensed Practical NurseNursing Service Providers

Taxonomy Code164W00000X

License✔ Licensed in MI · 4703101683

Definition

A licensed practical nurse with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

20201 ASBURY PARK ST, Detroit, MI 48235

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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nicole Pettway's NPI number?

The NPI number for Nicole Pettway is 1891091773. It was assigned to this individual provider in the NPPES registry on February 10, 2011.

Where is Nicole Pettway located?

Nicole Pettway practices at 20201 Asbury Park St, Detroit, MI 48235. The listed phone number is (313) 826-4449.

What is Nicole Pettway's specialty?

The primary specialty registered for this NPI is Licensed Practical Nurse with taxonomy code 164W00000X.

When was this NPI record last updated?

The NPPES record for Nicole Pettway was last updated on February 10, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.