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

Nicole Irene Back

Individual provider Registered Nurse · NPI 1013756576

Nicole Irene Back is a Nurse Practitioner in Waterford, Michigan. Qualified in 2024, 2 years ago. Practices with Clinton Urgent Care Walk in Clinic, a 2-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Michigan.

Years since qualifying
2
Licensed in
MI
In the registry since
2024
Specialties on file
2

Practice location Address checks out

5758 Cooley Lake Rd
Waterford, MI 48327-3073
Phone: (855) 466-3631
Show map & directions

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

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 4704247636 (MI)
Registered Nurse Taxonomy 163W00000X · Licence 4704247636 (MI)

Record details

NPI number1013756576
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMay 23, 2024
Last updated in NPPESMarch 6, 2025
Certification dateMarch 6, 2025
Mailing address5758 Cooley Lake Rd, Waterford, MI 48327-3073

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)
Group practice Clinton Urgent Care Walk In Clinic — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

Other providers in Waterford