Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Nicole Ann Mazourek

Individual provider Gerontology Nurse Practitioner · NPI 1568353225

Nicole Ann Mazourek is a Nurse Practitioner in Sioux Falls, South Dakota. Qualified in 2024, 2 years ago. Licensed in South Dakota.

Years since qualifying
2
Licensed in
SD
In the registry since
2025

Practice location Address checks out

1305 W 18th St
Sioux Falls, SD 57105-0401
Phone: (605) 312-5350
Fax: (605) 312-8928
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Gerontology Nurse Practitioner (primary) Taxonomy 363LG0600X · Licence CP003569 (SD)

Record details

NPI number1568353225
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJuly 11, 2025
Last updated in NPPESSeptember 29, 2025
Certification dateSeptember 29, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Accepts Medicare assignment Not indicated

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