Doctor Name: | DR. NICOLE KIMBERLY MARIA NURSE |
NPI Number: | 1518252477 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | D.O. |
License Number: | OT014171 |
Business Practice Address: | 2700 Grant St #200 Concord, CA - 945202266 |
Business Phone Number: | 9256770500 |
Business Fax Number: | 9256770519 |
Mailing Address: | Dept 34929, P.o. Box 39000 SAN FRANCISCO |
State: | CA |
Postal Code: | 941390001 |
Phone Number: | 9259522828 |
Fax Number: | 9259522850 |
NPI Enumeration Date: | 06/17/2011 |
NPI Last Update Date: | 11/11/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | OT014171 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | PA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |