Nicole Eller
Developmental Therapist in Jacksonville, FL. Individual provider (NPI-1).
NPI number1033723481
StatusActive
Last updated in NPPESJul 3, 2024
Details
- NPI
- 1033723481
- Entity type
- Individual (NPI-1)
- Name
- Nicole Eller
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 3, 2020
- Certification date
- Jul 3, 2024
- Last updated
- Jul 3, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 222Q00000X | Developmental Therapist | – | – | Yes |
| 106S00000X | Behavior Technician | RBT-20-133075 | FL |
Practice location
6907 Pickettville RdJacksonville, FL 32220-2475
Phone 904-510-2079
Mailing address
5 Revere Dr Ste 120Northbrook, IL 60062-8005
Phone 800-356-4049
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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