Organization
NICOLE PURSIFULL FAMILY PRACTITIONER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE PURSIFULL FNP (FNP/OWNER MANAGER)
(606) 269-6350
Entity
Organization
Contact information
Practice address
123 N 19TH ST STE 2, MIDDLESBORO, KY 40965-2865
(606) 269-6350
Mailing address
123 N 19TH ST, MIDDLESBORO, KY 40965-2865
(606) 269-6350
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1117450
KY
Other
Enumeration date
03/17/2017
Last updated
03/17/2017
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