| Doctor Name: | MRS. NICOLE LYNN STAPP |
| NPI Number: | 1114224219 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | WHNP-BC |
| License Number: | 4704244015 |
| Business Practice Address: | 1428 S Lapeer Rd Lake Orion, MI - 483601437 |
| Business Phone Number: | 2486930543 |
| Business Fax Number: | 2486304301 |
| Mailing Address: | Po Box 2137, BIRMINGHAM |
| State: | MI |
| Postal Code: | 480122137 |
| Phone Number: | 2486930543 |
| Fax Number: | 2486304301 |
| NPI Enumeration Date: | 02/25/2011 |
| NPI Last Update Date: | 11/18/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LW0102X |
| License Number: | 4704244015 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Women's Health |
| Taxonomy Definition: | |