Individual
NICOLE CHRISTINE PRIMOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM, WHNP
Contact information
Practice address
25 RALPH ST, BEACON, NY 12508-1842
(310) 359-2008
Mailing address
25 RALPH ST, BEACON, NY 12508-1842
(310) 359-2008
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
001801
NY
363LW0102X
Women's Health Nurse Practitioner
421306
NY
Other
Enumeration date
09/10/2017
Last updated
08/11/2022
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