| NPI | 1659635464 |
|---|---|
| Former Name | NICOLE E MCNICOL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP4534) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ RN144954) |
| Enumeration Date | 2012-06-26 |
| Last Update Date | 2022-02-04 |