Individual provider · NPI-1

Nicole M. Hackett, CSFA

Specialist/Technologist, Other, Surgical Assistant · Springfield, IL

NPI number1073220299
StatusActive
Last updated in NPPESOct 28, 2022

Details

NPI
1073220299
Entity type
Individual (NPI-1)
Name
Nicole M. Hackett
Credential
CSFA
Sex
Female
Sole proprietor
No
Enumeration date
Oct 28, 2022
Certification date
Oct 28, 2022
Last updated
Oct 28, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
246ZC0007X Specialist/Technologist, Other, Surgical Assistant––Yes

Practice location

1025 S 6th St
Springfield, IL 62703-2403

Phone 217-528-7541

Mailing address

1025 S 6th St
Springfield, IL 62703-2403

Phone 217-528-7541

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