| NPI | 1164772877 |
|---|---|
| Former Name | NICHOLE ANN PADJEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 5106-33) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 166788-30) |
| Enumeration Date | 2012-09-11 |
| Last Update Date | 2021-12-21 |