Individual
NICOLE SPANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
22 COURT ST, FREEHOLD, NJ 07728
(732) 780-7387
Mailing address
22 COURT ST, FREEHOLD, NJ 07728-1700
(732) 780-7387
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
26NR14764800
NJ
163W00000X
Registered Nurse
606476
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
26NJ00810400
NJ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
402203
NY
Other
Enumeration date
03/26/2013
Last updated
11/06/2018
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