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Individual
NICOLE MARIE MAIETTA
Active
Individual
NICOLE MARIE MAIETTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
SP017373
PA
363LF0000X
Family Nurse Practitioner
Primary
SP017373
PA
Other
Enumeration date
08/16/2017
Last updated
01/05/2019
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