Individual
NICOLE BLISS FERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP, MPH
Contact information
Practice address
1275 YORK AVE, NEW YORK, NY 10065-6007
(914) 227-6785
Mailing address
104 HIGH VIEW DR, CARMEL, NY 10512-6134
(914) 227-6785
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
382953
NY
363LP0200X
Pediatric Nurse Practitioner
7582
CT
363LP0200X
Pediatric Nurse Practitioner
RN2310326
MA
Other
Enumeration date
07/21/2017
Last updated
04/14/2019
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