Individual
DIANE A NICHOLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
5925 15TH AVE, BROOKLYN, NY 11219-5009
(718) 972-2700
(718) 532-1724
Mailing address
5925 15TH AVE, BROOKLYN, NY 11219-5009
(718) 972-2700
(718) 532-1724
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
F000305-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01556629
—
NY
Enumeration date
06/28/2005
Last updated
01/08/2014
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